Treatment of Otitis media

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Around 80% of cases of acute otitis media clear up within three days without any treatment. Perforated ear drums also usually heal by themselves.

While antibiotics may help with the short-term symptoms, there is no evidence that they make otitis media clear up faster or reduce the chance of complications happening. They may be prescribed if the infection is severe or is getting worse after 2-3 days. Long-term antibiotics can help prevent long-term or recurrent otitis media, but they have side effects, and research has not been able to prove they are the best treatment.

Over the counter pain killing drugs like paracetamol or ibuprofen may be used to control the symptoms of otitis media (pain and fever). Aspirin should not be given to children under the age of 16.

Nose drops containing decongestants or antihistamines may be used to reduce the swelling of the mucous membranes in the nose and back of the throat. In theory, this will help to keep the Eustachian tubes clear and allow mucus to drain from the middle ear, but again, this has not been proved to be an effective treatment for otitis media.

In adults with chronic otitis media, drops containing antibiotic drugs have been shown to help reduce the amount of pus coming from the ear.

For children with recurrent severe otitis media, tiny tubes may be inserted through the eardrum to help drain fluid. These tubes are also known as grommets or tympanostomy tubes. They are not recommended in all cases, because there is a chance that the grommets may cause other problems, and may themselves become infected or blocked. There are similar risks for an operation called a myringotomy, when a small hole is made in the eardrum to allow fluid to drain; this too is not proven to help prevent further infections.

Removal of the adenoids and tonsils may help if they are blocking the entrance to the Eustachian tube.