Treatment of Middle Ear Infections – Antibiotics


Antibiotics are frequently overused for the treatment of middle ear infections (otitis media). Somewhere between 30-50% of ear infections are bacterial. They are most commonly caused by bacteria like Streptococcus pneumonia and Haemophilus influenzae. Viruses can also trigger ear infections, and in these cases antibiotics are useless.

The diagnosis of otitis media, is based on ear pain associated with fever. The ear drum appears red and bulging and the patient feels irritable and restless. In younger children the pain can be so intense as to make them scream and cry.

For the treatment of middle ear infection, a responsible doctor should advise you to wait at least a couple of days, before prescribing antibiotics. Pain killers may be recommended if necessary to dull the pain. This “watch and wait” technique will determine if an antibiotic is really needed.

Studies show that about 90% of children get better just as fast, with no significant differences in speed of relief of pain, how quickly temperature returned to normal, how soon ear discharge stopped or other symptoms – whether they have antibiotics or not.

In one 2000 study, 240 children under age two who were diagnosed with acute otitis media were just watched carefully. After four days, only 3% of the children required treatment with antibiotics, while the infection cleared itself naturally in the other 97%.

When antibiotics are repeatedly used for the treatment of middle ear infection in children, it increases the chances of further infection by up to 600 percent. It also increases the chances that surgery will ultimately be needed. In the 1970s, out of 10,500 children who underwent treatment of middle ear infection without antibiotics, Danish researchers found that over the following 14 years, only 15 required ear operations. This was very low compared to children having surgery after repeated courses of antibiotics.

A 1983 study published in the British Medical Journal showed that in adults who develop active chronic otitis media, there is no benefit at all in using antibiotics.

If antibiotics are needed then make sure you support the immune system so that complications do not arise, and that repeat antibiotic scripts are not required. Be aware that studies have shown that short courses of antibiotics for the treatment of middle ear infection, from two to five days, are equally effective as a ten day course.