How Middle Ear Infections Are Treated

Proper treatment of an ear infection—also known as acute otitis media (AOM)— will greatly reduce the amount of ear pain that you are experiencing, as well as decrease your risk of other complications from an untreated infection. Options include over-the-counter therapies and prescription medications that your healthcare provider can prescribe.

Signs of ear infections in kids

Verywell / Brianna Gilmartin

Explore these treatments for both pain and fighting the infection, as well as other treatments that you may want to understand.

Over-the-Counter Therapies

Pain is one of the most bothersome symptoms of an ear infection.

Antibiotics will not help control ear pain (otalgia) for about 24 hours. Until antibiotics have had a chance to start working, you can use over-the-counter medications to help control the pain.

Ibuprofen or acetaminophen are the preferred options for children. Children under the age of 2 sometimes experience pain for three to seven days, so you will want to tailor the length of OTC pain control to how your child is reacting. You should ask your healthcare provider about over-the counter medications to ensure that you provide the right dose.

In general, here are standard doses for both ibuprofen and acetaminophen.


  • Children: 4 to 10 mg per kg every 6 to 8 hours as needed
  • Adults: 200 to 400 mg every 6 hours as needed


  • Children under 6 years old: 10 to 15 mg per kg every 4 to 6 hours as needed
  • Children 6 to 12 years old: 325 to 650 mg every 4 to 6 hours (not to exceed 1.625 grams per day)
  • Children greater than 12 years old: 325 to 650 mg every 4 to 6 hours (not to exceed 3.25 grams per day)

Calculating Children's Dosage

Dosing for children is usually listed in kg (kilograms). To calculate this, take your child's weight in pounds and divide it by 2.2. You will then need to multiply your child's weight in kilograms by the recommended dose per kilogram.

If you're using liquid medication, the side of the box lists how many milligrams are in each milliliter. You can draw the appropriate amount in either a syringe or pour into a medicine cup.


A diagnosis of an ear infection will require antibiotics. Amoxicillin has been a successful first-line choice for over 25 years. It covers most variants of S. pneumonia but a smaller percentage of the variants of the other less common community-acquired ear infections: nontypable H. influenzae and M. Catarrhalis.

However, amoxicillin is usually successful for treating an ear infection and another choice may not be needed unless you have an allergy to penicillin. If you have an allergy to penicillin, your healthcare provider may prescribe you a cephalosporin such ascefdinir, cefpodoxime, cefuroxime, ceftriaxone,or perhaps another class of antibiotic.

Ear Infection Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Child

Amoxicillin Dosage

Usual dosing may sometimes be based on the severity of the ear infection.

For adults:

  • Mild to moderate: 500 mg every 12 hours
  • Severe: 875 mg every 12 hours

For children:

  • 80-90 mg/kg per day in 2 divided doses

There are alternate dosing styles that your healthcare provider may want to use based on your symptoms or previous treatment history. A severe ear infection is usually classified as having severe hearing loss, high temperature, or severe ear pain.

Ear Drops

If over-the-counter pain medicine is not sufficient for pain control, your healthcare provider may prescribe ear drops that contain a topical anesthetic.

It is important to know that you should not use any ear drops with anesthetics if you have ear tubes in place.

Treatment Duration

Treatment will typically last for 5 to 7 days for the standard ear infection. However, your healthcare provider may prescribe up to 10 days for a severe ear infection.

Frequently Asked Questions

  • What are the symptoms of a middle ear infection?

    Symptoms of a middle ear infection include ear pain (especially in one ear or when lying down), hearing loss, a feeling of fullness in one ear, feeling generally ill, or ear drainage.

  • How can I tell if my toddler has an ear infection?

    Since small children might not be able to tell you what they're feeling, diagnosing an ear infection in toddlers can be tricky. Look for the following signs if you suspect your child has an ear infection: ear pain, high fever, difficulty sleeping, hearing issues, clumsiness or balance problems, and ear fluid drainage.

  • Are there homeopathic treatments for an ear infection?

    Homeopathic treatments do exist for ear infections. However, there is little scientific evidence that they are effective. Homeopathic remedies should not be used in place of conventional medicine. Speak to your healthcare provider before trying them so that you receive the best treatment and avoid further ear pain.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Merck Manual Professional Edition. Otitis Media (Acute)

  2. Mayo Clinic. Ear infection (middle ear)

  3. Marom T, Marchisio P, Tamir SO, Torretta S, Gavriel H, Esposito S. Complementary and alternative medicine treatment options for otitis media: A systematic reviewMedicine (Baltimore). 2016;95(6):e2695. doi:10.1097/MD.0000000000002695

Additional Reading
  • Acute otitis media in adults. UpToDate website. (subscription required). Updated April 19, 2017.
  • Acute otitis media in children: Diagnosis. UpToDate website. (subscription required). Updated October 13, 2017.
  • Lieberthal, AS, Carroll, AE, Chonmaitree, T, Ganiats, TG, Hoberman, A ... Tunkel, DE. (2013). The Diagnosis and Management of Acute Otitis Media. Pediatrics 131(3), e964-e999.

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.