Antibiotics for middle ear infection


Generic Name Brand Name
amoxicillin Amoxil, Trimox
amoxicillin and clavulanate potassium Augmentin
cefpodoxime proxetil Vantin
ceftriaxone Rocephin
cefuroxime Ceftin
trimethoprim/sulfamethoxazole Bactrim, Septra

How It Works

Antibiotics kill bacteria.

Most antibiotics are given in pill or liquid form. Sometimes the first dose of an antibiotic is given as a shot. Ceftriaxone is one example. It's often given just once, although in some situations a shot is given each day for 3 days in a row.

Why It Is Used

Antibiotics often clear up a bacterial ear infection. Amoxicillin is an antibiotic often chosen for treating ear infections. It works well and costs less than other brands.

Doctors sometimes prescribe antibiotics to prevent infections in children who are prone to repeated ear infections (recurrent otitis media). But experts disagree on how helpful this is.

How Well It Works

Antibiotics are effective in most cases of ear infections caused by bacteria. But only 1 out of 5 children with ear infections needs antibiotics to clear an ear infection. In 4 out of 5 children, ear infections clear on their own.1

A child with an ear infection should feel better within 48 hours after taking antibiotics. If your child doesn't feel better, call your doctor. Your child may need a different antibiotic.

Antibiotics will not be effective if the ear infection is caused by a virus. Waiting before starting an antibiotic can save your child from taking medicine that he or she doesn't need.

Some doctors suggest antibiotics for children who don't have symptoms but are prone to repeat ear infections. Studies show that this preventive method doesn't always work.1 Taking antibiotics when they may not be needed can lead to new types of bacteria that can't be killed (antibiotic-resistant bacteria). This means that children may not respond to an antibiotic when they really need it, such as if they get pneumonia.

Antibiotics may help with fluid behind the eardrum that won't go away (chronic otitis media with effusion). But the fluid may return.

Side Effects

Common side effects of antibiotics include:

Less common and more serious side effects of antibiotics include:

Use of antibiotics to treat ear infections increases the risk for antibiotic-resistant bacteria.

Children who have been given ceftriaxone may complain of pain at the site of the shot.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

In many countries other than the United States, antibiotics are prescribed much less frequently for ear infections.

If a child with an ear infection appears very ill, is younger than age 2, or is at risk for complications from infection, doctors usually prescribe antibiotics right away. For children ages 2 and older, many doctors suggest that parents wait a day or two before starting antibiotics. If the child starts to get better, no antibiotics are needed. If symptoms don't improve, then you can start giving the antibiotic.

Amoxicillin is often the first choice for treating ear infections because it works well, most children can take it, and it costs less than some other antibiotics.

Experts are looking at how well antibiotics work in clearing ongoing fluid behind the eardrum (chronic effusions). Antibiotics may clear the fluid from behind the eardrum for a short time. Other treatment, such as tube insertion, may help clear fluid from behind the eardrum.

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  1. Bradley-Stevenson C, et al. (2007). Otitis media in children (acute), search date January 2007. Online version of BMJ Clinical Evidence. Also available online:

Last Updated: February 2, 2009

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