Duration Health

Ear

Introduction

Ear pain can be due to injury/trauma to the ear or due to infection. There are 2 main types of ear infections. The first is called otitis media, which is an infection of the middle ear, or the area behind the eardrum. This can cause throbbing, sharp, or stabbing pain to the ear, which may radiate down into the throat, feeling of ear fullness, muffled hearing, fever and sometimes, if severe, a yellow discharge can drain from the ear. Another kind of infection of the ear, is called otitis externa, this is an infection of the outer ear canal, and is called “swimmer’s ear” as it is commonly caused by water that remains in the ear after swimming with allows a moist environment for bacterial growth. Symptoms of otitis externa include, itching and discomfort of the outer ear and canal, redness of the skin of the ear, pain when you tug on the earlobe, draining yellow fluid.

Ear infections can spread past the ear and into the bones behind the ear within the skull. The bony bump behind the ear, called the mastoid process, can become infected (mastoiditis). This is a serious infection requiring emergent medical attention. Ear infections can spread to the brain, causing meningitis. Ear infections can also spread to the skin of the ear and the skin surrounding the ear, in a serious infection called malignant otitis externa.

Treatment

Otitis media is treated with oral antibiotics, most commonly amoxicillin or amoxicillin-clavulanate. Otitis externa is treated with ear drops, called ofloxacin.

When To Worry

Seek immediate medical care if you have any of the following:

Quick Guide

If you have

  • inner ear pain
  • drainage from ear
  • fever

You may have

otitis media

Consider using

amoxicillin-clavulanate 875 mg-125mg twice daily for 7 days

Note: if amoxicillin alone is available, amoxicillin alone should be used instead of amoxicillin-clavulanate combination

OR

azithromycin 500 mg by mouth the first day, then 250 mg per day for the next 4 days

Note: if amoxicillin is unavailable or if an allergy to penicillins is present, azithromycin may be considered as an alternative. However, it is ineffective against some organisms responsible for otitis media.

OR

doxycycline 100 mg by mouth twice daily for 5 days

If you have

  • ear pain or itching
  • redness of skin of ear
  • pain when you tug on earlobe
  • no fever
  • recent swimming

You may have

otitis externa

Consider using

ofloxacin 10 drops in the affected ear 2 times per day for 10-14 days

If you have

  • ear pain that spreads to the face or area behind the ear
  • redness of the skin around ear
  • hearing loss
  • facial paralysis
  • dizziness
  • confusion or behavior change
  • persistent fever

You may have

meningitis or cellulitis or mastoiditis

You should

seek emergency medical care

Reference

Ofloxacin is an antibiotic. Ofloxacin drops can be used to treat eye or ear infections.

InfectionMedication

Amoxicillin-clavulanate (generic for Augmentin) is an antibiotic. It can be used to treat skin infections like bite wounds, ear infections, sinus infections, tooth infections, and other infections. This medication should be taken with food.

InfectionMedication

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