How Adult Ear Infections Are Treated

Ear infections occur when there is fluid buildup in the ear that causes blockages and inflammation. While ear infections are commonly thought of as a childhood illness—and they are more common in children—ear infections can also occur in adults.

This article will discuss the types of ear infections as well as symptoms and treatment.

Woman receiving ear exam from young doctor.

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Anatomy of an Ear Infection

The ear is divided into the outer ear, middle ear, and inner ear. Infection can occur in any of these areas, but bacterial infections of the inner ear are extremely rare.

Different types of germs can cause infections in the ear, including bacteria, viruses, and even fungi. Infections can be brought on by an illness, such as a cold or allergies.

Ear infections generally occur when a germ gains entry into one of the three areas of the ear and grows there.

Outer Ear Infection

Outer ear infections are sometimes called swimmer's ear, or otitis externa. This is an infection of the ear canal, the portion of the ear that leads from the outside and stops at the eardrum. The opening of this part of the ear is external and visible.

Outer ear infections are called swimmer's ear because they can sometimes be caused by swimming or bathing in contaminated water.

This is not the only way to get an outer ear infection, however. Germs can be introduced to the outer ear in many ways, especially through broken skin, and usually result in an infection when a moist environment aids their growth.

Symptoms of an outer ear infection can include:

  • Pain in the ear
  • Redness and irritation inside the ear canal
  • Itchy ear canal
  • Flaky or peeling skin

More severe infections can lead to swelling of the ear canal, which may lead to muffled hearing, a fever, or ear drainage that looks like there is pus in it.

Preventing Outer Ear Infections

The best way to prevent outer ear infections is to keep your ears as clean and dry as possible. Never put objects into your ear canal, and gently dry your ears after swimming or bathing. You can do this by tipping your head to the side and allowing the water to run out.

Middle Ear Infections

The middle ear is internal. It starts behind the eardrum and goes to the oval window. It contains three tiny bones, called the ossicles, that are necessary for hearing function.

The auditory tube (Eustachian tube) runs from the middle ear to the throat. Its function is to ventilate and equalize pressure in the middle ear. Fluid from the middle ear space drains into the throat and is usually swallowed.

Types of Middle Ear Infections

Middle ear infections are called otitis media. When otitis media is accompanied by fluid in the middle ear, ear infections are referred to as serous otitis media, or otitis media with effusion.

Middle ear infections are extremely common during childhood. The age group most affected are children 3 months old to 3 years old.

Adults have a more vertical auditory tube than children, whose auditory tubes are level and smaller. This anatomical difference is the reason for the higher number of middle ear infections experienced in childhood.

However, middle ear infections can occur in adults as well.

Middle ear infections often occur after a cold virus or upper respiratory infection. They are also more common in individuals who suffer from allergies or enlarged adenoids (tissue in the throat and nasal cavity), which can inhibit proper functioning of the auditory tube.

Germs often enter through the auditory tube, which can then become swollen and blocked with mucus, preventing drainage and ventilation of the middle ear.

The main symptoms of middle ear infections include:

  • Ear pain, which may be worse in the morning or cause difficulty sleeping
  • Ear drainage
  • Hearing loss
  • Fever

A doctor can diagnose a middle ear infection based on symptoms and an examination, which involves looking at the eardrum with an otoscope (a special tool with a light on the end that makes it easy to see inside the ear).

Inner Ear Infection

The inner ear is located next to the middle ear within the temporal bone. The inner ear contains the semicircular canals, which are essential to balance and equilibrium.

Inner ear infections, also called labyrinthitis or vestibular neuritis, are much less common than outer ear infections or middle ear infections. Inner ear infections are much more likely to be caused by a virus than a bacterial infection.

While both are inner ear infections, labyrinthitis and vestibular neuritis are slightly different conditions.

Labyrinthitis affects the labyrinth, which is a system of fluid-filled sacs that helps you hear and gives you a sense of balance. Labyrinthitis can cause both hearing changes and dizziness, or vertigo.

Vestibular neuritis is an inner ear infection that affects the vestibular nerve and usually causes dizziness and balance issues, but no hearing changes.

Diagnosing Inner Ear Infections

There is no specific diagnostic test to identify an inner ear infection, so misdiagnosis or delayed diagnosis is common.

Outer Ear Infection Treatment

OTC Treatments

Over-the-counter (OTC) pain medications, including Advil or Motrin (ibuprofen) and Tylenol (acetaminophen), may be used to ease the pain associated with an outer ear infection.

You can also use a warm compress to help with pain.

There are various at-home remedies recommended for swimmer's ear, including rubbing alcohol, vinegar, or baby oil, but you should consult with your physician before using any of these substances for swimmer's ear.

Avoid Giving Children Aspirin

Aspirin use in children can cause a serious, sometimes fatal, disorder called Reye's Syndrome. Avoid giving your child aspirin for their ear infection and ask your pediatrician for other treatment options.

Prescription Medications

Antibiotic ear drops are often prescribed for the treatment of outer ear infections. Some prescribed ear drops, such as Ciprodex (ciprofloxacin and dexamethasone), combine an antibiotic and a steroid medication to help with inflammation.

Ear drops should be used exactly as prescribed and for the correct length of time.

Oral antibiotics are not usually necessary for the treatment of outer ear infections, but some circumstances may require their use. If you are prescribed oral antibiotics, make sure you take them exactly as they are prescribed unless otherwise instructed by your physician.

Middle Ear Infection Treatment

Ear infections can typically resolve themselves, so treatment is focused more on symptom management to provide pain relief.

OTC Treatments

OTC pain relievers, such as ibuprofen and acetaminophen, can be given to ease the pain associated with a middle ear infection. These medications are also capable of reducing a fever if one is present.

Sometimes using a warm compress and keeping the upper body elevated to help the auditory tube drain can help to alleviate the pain caused by a middle ear infection.

Prescription Medications

Antibiotics are only effective in treating a middle ear infection that is caused by bacteria.

However, it is not always possible to identify the germ—whether bacterial or viral—causing a middle ear infection. Your physician may choose to treat the infection by prescribing an antibiotic or waiting to see if the infection improves on its own.

Inner Ear Infection Treatment

OTC Treatments

Benadryl (diphenhydramine) and Antivert (meclizine) are two OTC medications that may be used to treat the dizziness and nausea associated with an inner ear infection.

These medications can help alleviate symptoms but do not treat the actual infection.

Prescription Medications

Several different prescription medications may be used for the treatment or management of symptoms caused by an inner ear infection, including:

  • Antinausea medications
  • Steroid medications, such as prednisone, to reduce inflammation
  • Antibiotics or antiviral medications

Possible Complications

Outer Ear Infection

Complications are rare, but some people are at a higher risk, including those with impaired immune systems, diabetes, or those undergoing cancer treatments that make it difficult for the body to fight off an infection.

If left untreated, outer ear infections can lead to a condition called malignant otitis externa, whereby the infection spreads to nearby tissues and bones, causing severe damage.

Middle Ear Infection

Some people can suffer from chronic or recurring middle ear infections. While rare, several complications may occur from persistent or untreated middle ear infections including:

  • Mastoiditis: A condition in which the infection spreads to the mastoid bone behind the ear
  • Cholesteatoma: A rare condition associated with middle ear infections that causes the skin cells in the middle ear to grow abnormally
  • Inner ear infections: Labyrinthitis and vestibular neuritis, which sometimes occur from untreated middle ear infections
  • Meningitis: An infection of the meninges, the protective space filled with cerebral spinal fluid that cushions the brain and spinal cord
  • Developmental problems: In children, prolonged hearing impairment from middle ear infections that inhibits speech development
  • Facial paralysis: A rare condition in which the facial nerves are compressed

Inner Ear Infection

Excessive nausea and vomiting may lead to hospitalization and the need for intravenous fluids in individuals with inner ear infections.

Permanent hearing loss or chronic vestibular problems (issues with balance and dizziness) may also be complications of an inner ear infection.

A Word From Verywell

Having an ear infection can be painful and interfere with your ability to function. It's important to remember that almost all ear infections can be cured with prompt treatment. If you have symptoms of an ear infection, meet with a healthcare professional to discuss your condition.

Frequently Asked Questions

  • How do you know if an ear infection is bacterial or viral?

    It is not always possible to identify the exact germ causing an ear infection. However, if ear drainage is present, it is possible a sample of the drainage can be sent to a laboratory for testing and the germ may be identified.

  • Are there any home remedies to ease the pain of an ear infection?

    Over-the-counter pain relievers are often effective at alleviating the pain associated with an ear infection. Heating pads can also be helpful, if the temperature is regulated properly. For middle ear infections, keeping your upper body elevated may reduce some of the pressure in the ear.

  • Will an ear infection clear up without antibiotics?

    Some ear infections will clear up without antibiotics. If your symptoms are mild or your physician suspects a virus, they may choose not to prescribe antibiotics but rather monitor the infection to see if it gets better on its own.

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9 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.
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