Your Health A-Z

Ear infections and antibiotics

We speak to a GP about the causes and treatment of ear infections in children – and when antibiotics are necessary.

Children experience ear infections more often than adults, as their resistance to bacteria and viruses is still underdeveloped. In most cases, ear infections start after a child has had a cold or the flu.

Common symptoms of ear infections include a sore throat, fever if it is an acute infection, and pain in one or both ears. Children, and some adults, may also experience loss of appetite, vomiting and general malaise. In some cases there may be a thick, yellow or bloody drainage from the ear. This means the eardrum has burst or ruptured and will take a few months to heal.

Catch it early

‘Early intervention is key to treating an ear infection – with or without antibiotics,’ says Dr Clive Landman, a GP at Medipark, Centurion. ‘An untreated, recurring or chronic ear infection can lead to hearing problems, and a child who does not hear well does not perform well at school. Hearing is absolutely crucial.’

In general, the symptoms of ear infection, although painful, tend to improve within the first couple of days – and contrary to popular belief, antibiotics are not always necessary. This is especially the case if the ear infection is of viral origin, as it will probably clear up on its own within two weeks or less.

Ear infections and antibiotics in babies

However, in babies and children under the age of two, ear infections should be closely monitored because they can easily result in accumulated fluid that then causes a bacterial infection. In this case, antibiotics may be a good option to help speed up the process of healing and prevent any further complications. Doctors are likely to wait a few days to see if the ear infection will clear up on its own before prescribing an effective antibiotic, usually a penicillin/clavulanate combination.

‘Many ear infections can be treated with good drainage, and it does not have to be surgical,’ says Dr Landman. More often than not, I will give an antibiotic only if the child remains feverish or if the initial examination shows a rupture of the eardrum. If treatment is sought early and the sore ear fluid can be lessened, very often an antibiotic proves unnecessary.’

Besides medication, plenty of rest and regular intake of fluids will help to clear the infection or alleviate the symptoms. Applying a heat press to a painful ear can also be helpful. If you suspect your child has an ear infection, the symptoms persist for more than a few days or your child starts running a fever, take them to your GP or paediatrician.

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.