Diagnosis and Treatment of acute middle ear infection

Diagnosis of acute middle ear infection

Your GP will ask about your child's symptoms and examine your child. They may also ask about their medical history. Your GP will use an instrument called an otoscope to look at your child's eardrum.

Your GP may refer your child to have a tympanometry test if the infection keeps coming back or if they suspect glue ear. This is usually done by an audiologist – a technician or scientist who specialises in hearing and balance problems. This can measure how flexible your child’s eardrum is. If your child has an acute middle ear infection, their eardrum stiffens up because of the fluid behind it.

If your child is under three months old, your GP may advise that you take him or her to hospital for further assessment.

Treatment of acute middle ear infection

Self-help

Often, the best treatment for an acute middle ear infection is to relieve your child’s symptoms with painkillers until the inflammation has cleared up. For example, paracetamol (eg Calpol) or ibuprofen (eg Nurofen for Children). Don’t give aspirin to children under 16. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. If your child’s condition doesn’t clear up after a few days, or it gets worse, see your child's GP.

Medicines

Usually, acute middle ear infections clear up on their own within four days and no antibiotics are needed. For this reason, your GP may give you a ‘delayed prescription’, one which you can’t use until your child has had symptoms for at least four days.

If your child has already had symptoms for four days, your GP may prescribe antibiotics to start straight away. Also, if your child is under two and both their ears are infected, then antibiotics may be prescribed sooner. This may also be the case if they have a very high temperature or perforated eardrum (a hole or tear in their eardrum).

If your child is very young (under three months) your GP may recommend starting antibiotics straight away. Your GP may also refer your child to a hospital for further treatment.

If your child does have antibiotics, it's important to complete the course even if their symptoms get better. Decongestant or antihistamine medicines are unlikely to help. Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

Surgery

If your child gets several acute middle ear infections in a six-month period, your GP may decide to refer them to an ear, nose and throat (ENT) specialist. They may also refer your child if a burst eardrum takes longer than one month to heal. Your child may need surgery if he or she has recurrent infections (three or more infections within six months).

Surgery may involve a procedure called a myringotomy. This procedure involves a small cut being made in your child's eardrum so that fluid can drain out. Ventilation tubes called grommets or tympanostomy tubes may also be inserted into the cut in your child's ear. These are small plastic tubes that allow air to get in and out of the ear. Ask your doctor for more information.

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