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Ears, nose & throat

Ear Infection: How Is It Treated?

By The Tessan Editorial Team · July 23, 2026 · 4 min read

Also known as: Otitis, Otitis media, Middle ear infection, Swimmer's ear, Otitis externa

What is an ear infection?

Otitis is inflammation or infection of the ear, most often bacterial or viral. It is one of the most common infections in children: according to the National Institute on Deafness and Other Communication Disorders, five out of six children will have at least one ear infection by their third birthday. It is also the most common reason parents bring a child to a medical provider.

The main forms are acute otitis media, which sits behind the eardrum, and otitis externa, which affects the ear canal.

Causes and risk factors

Acute otitis media often follows an upper respiratory infection such as a cold or sinus congestion. Bacteria or viruses spread to the middle ear through the eustachian tube, which is smaller and more level in children than in adults. That anatomy makes fluid harder to drain, so it collects behind the eardrum.

Otitis externa is encouraged by moisture. When water stays trapped in the ear canal, the bacteria that normally live on the skin multiply. Hot tubs, cleaning the canal with cotton swabs, hair spray or dye, eczema of the canal, and contaminated hearing aids or earbuds all raise the risk.

In infants, attending daycare, secondhand smoke exposure, bottle-feeding while lying down, and an immune system that is still maturing all increase the odds of a middle ear infection.

Symptoms

Acute otitis media causes intense ear pain, often with fever, disrupted sleep, and irritability in young children who cannot yet say what hurts. Parents may notice tugging at the ears, unusual crying, fluid draining from the ear, balance problems, or trouble hearing. A ruptured eardrum can relieve the pain suddenly.

Otitis externa causes pain that gets worse when you tug on the outer ear, sometimes with itching, a blocked sensation, drainage, or reduced hearing. Severe cases can bring swelling and pain radiating toward the neck or face.

Diagnosis

Diagnosis relies on otoscopy, a visual exam of the eardrum performed by a doctor with a lighted otoscope. An infected eardrum looks reddened and bulging. A pneumatic otoscope adds a puff of air to see how well the eardrum moves, which tells the doctor whether fluid is sitting behind it.

This quick exam distinguishes a middle ear infection from an outer ear infection and is what determines whether antibiotics are needed.

Available treatments

Treatment depends on the type of ear infection and the patient’s age.

Children with repeated infections may be referred for surgical placement of ear tubes, which relieves pressure and restores hearing.

Prevention

To reduce ear infections, keep a child away from secondhand smoke. Protect the ears while swimming with earplugs and dry them thoroughly with a towel afterward. Do not use cotton swabs to remove earwax: they push debris deeper, strip away protective wax, and irritate the lining of the canal.

Breastfeeding helps protect infants against ear infections. Vaccination matters too. The pneumococcal conjugate vaccine and the annual flu vaccine both lower the risk, and vaccinated children have significantly fewer ear infections.

When should you see a doctor?

See a doctor if pain persists despite pain relievers, if there is high fever or drainage from the ear, or if an infant is unusually irritable and refuses to eat.

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