Otitis media (earache)

This advice is intended for parents/carers taking their child home after consulting a doctor. Your doctor may recommend different treatments depending on your child's condition.

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Treatment

Most children with otitis media (earache) do no require treatment with antibiotics. Antibiotics rarely speed up recovery and often cause side effects such as rash and diarrhoea. They will also promote the development of antibiotic resistant bacteria in your child.

Antibiotics are usually only considered if your child:

Is under 6 months of age and has otitis media
Has pus draining from their ear
Has a serious health condition that makes them more vulnerable to serious infection

In addition, if your child has any features of severe infection (red or amber features as described below), they will need to be urgently assessed by a healthcare professional.

You can help relieve symptoms by:

Giving your child paracetamol or ibuprofen to help relieve pain
Encouraging your child to drink plenty of fluids

Prevention

Is it not possible to prevent ear infections; however, you can do things that may reduce your child's chances of developing the condition:

Ensure your child is up-to-date with their immunisations
Avoid exposing your child to smoky environments (passive smoking)

When should I get help?


If your child has any of the following: Is going blue around the lips Has pauses in their breathing or has an irregular breathing pattern Too breathless to talk/eat or drink Becomes pale, mottled and feels abnormally cold to touch Has a fit/seizure Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake) Develops a rash that does not disappear with pressure (the 'Glass Test') Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless within 48 hours of vaccinations)	You need urgent help. Go to the nearest Hospital Emergency Department or phone 999

If your child has any of the following:

Is going blue around the lips
Has pauses in their breathing or has an irregular breathing pattern
Too breathless to talk/eat or drink
Becomes pale, mottled and feels abnormally cold to touch
Has a fit/seizure
Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
Develops a rash that does not disappear with pressure (the 'Glass Test')
Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless within 48 hours of vaccinations)

You need urgent help.

Go to the nearest Hospital Emergency Department or phone 999


If your child has any of the following: Has pus coming out of the ear Develops swelling behind the ear or increasing pain / redness behind the ear Develops dizziness or is losing their balance Is becoming drowsy (excessively sleepy) or irritable (unable to settle down with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down Is complaining of a severe headache and neck stiffness/pain or discomfort with bright lights (photophobia) Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breath in) Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours) Has extreme shivering or complains of muscle pain Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations) Continues to have a fever of 38.0°C or above for more than 5 days Is getting worse or if you are worried	You need to contact a doctor or nurse today. Please ring your GP surgery or call NHS 111 - dial 111

If your child has any of the following:

Has pus coming out of the ear
Develops swelling behind the ear or increasing pain / redness behind the ear
Develops dizziness or is losing their balance
Is becoming drowsy (excessively sleepy) or irritable (unable to settle down with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
Is complaining of a severe headache and neck stiffness/pain or discomfort with bright lights (photophobia)
Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breath in)
Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
Has extreme shivering or complains of muscle pain
Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
Continues to have a fever of 38.0°C or above for more than 5 days
Is getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111


If none of the above features are present Continue providing your child’s care at home.	Self care Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

If none of the above features are present

Continue providing your child’s care at home.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative

Last reviewed: 16/11/2020

Next review date: 21/06/2023

Author(s): Dr Geetika Kumar, Healthier Together.

Otitis media (earache)

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Treatment

Prevention

When should I get help?

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