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Ear Infections

Edited by Dr Claudia Pastides, 15th March 2019


Otitis media is inflammation of the middle ear, most commonly seen in children under the age of 4 and caused by a combination of viruses and bacteria.


Causes

Both bacteria and viruses are responsible for middle ear infections.

Risk factors

  • Young children
  • Attending childcare settings and play groups, or having older siblings
  • Autumn or winter season
  • Not being breastfed as an infant (breastfeeding protects against otitis media)1
  • Exposure to tobacco smoke or pollution
  • Family history of middle ear infection
  • Having a weakened immune system

Typical Symptoms

  • Fever
  • Ear pain (rubbing at the ear in infants)
  • Fluid leaking from the ear
  • Irritability
  • Headache
  • Disturbed sleep
  • Poor feeding (in infants)
  • Vomiting
  • Diarrhoea

Common Treatment

Treatment depends on symptoms and examination findings. Usually a one-sided ear infection in an otherwise well and healthy child or adult will resolve within a week without the need for treatment other than over the counter painkillers.

However, some will benefit from antibiotics and your GP will advise you whether you need to take the antibiotics straight away or they might recommend a “delayed prescription”, meaning that if the symptoms worsen or don’t improve then you would be advised to take them.

When to speak to a doctor

If you think you have an ear infection, you will need a face to face appointment to have your ears examined.

It is important to speak to a doctor urgently if:

  • Your baby is under 3 months of age and you think they have an ear infection or fever
  • Your baby is 3-6 months of age and has a fever of 39oC or more
  • You are an adult with persistent ear infection lasting longer than 6 weeks
  • You feel increasingly unwell
  • You are struggling to hear properly
  • You/the person with an ear infection experiences confusion or decreased consciousness
  • You experience facial paralysis
  • You experience a loss of balance

Prevention

Otitis media can be managed and prevented by:

  • Breastfeeding infants
  • Avoiding cigarette smoke or pollutants



More information

NHS - https://www.nhs.uk/conditions/ear-infections/



References

1. Bowatte, G. (2015) Breastfeeding and childhood acute otitis media: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):85-95.