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Otitis Media Pediatric Care Plan

By Chelsea Johnson, MD, FAAP
Medically reviewed checkmarkMedically reviewed
December 9, 2020

What is Otitis Media?

Otitis media is the medical name for middle ear infection. Kids under 5 years old are at a higher risk for ear infections, especially after upper respiratory infections (like a cold).

A cold, throat infection, acid reflux, or allergies can make the eustachian tubes swell. This blocks the mucus from draining. Then, viruses or bacteria grow in the mucus and make pus, which builds up in the middle ear.

This creates pain and pressure. Most ear infections are painful but clear up without any lasting problems.

A doctor can determine whether treatment with antibiotics can help. If a child has a history of many ear infections, a doctor might recommend ear tube surgery.

Most middle ear infections are a complication of a respiratory infection. The virus or bacteria that led to the middle ear infection may be contagious but no more worrisome than other germs that cause the common cold.

Click to Read More about Otitis Media

How Are Ear Infections Diagnosed?

Pediatricians will examine the ear using an otoscope, a small instrument similar to a flashlight, to see the eardrum. They can determine if the ear canal is infected (swimmer’s ear), the middle ear is infected (otitis media) or otitis media with effusion, when non-infected fluid builds up in the ear. It might not cause symptoms, but in some kids, the fluid creates a sensation of ear fullness or “popping.”

How Long Do Ear Infections Last?

Middle ear infections often go away on their own within 2 or 3 days, even without any specific treatment.

Symptoms of ear infections may include:

  • Pain inside the ear
  • Fussing, irritability, crying, poor feeding
  • Ear drainage
  • ear fullness or popping
  • Fever may be present

How Are Ear Infections Treated?

To treat an ear infection, pediatricians consider many things, including:

  • The type and severity of the ear infection
  • How often your child has ear infections
  • How long this infection has lasted
  • Your child’s age and any risk factors
  • Whether the infection affects hearing

You might be wondering if antibiotics can help your child’s ear infection. Antibiotics aren’t routinely prescribed because they:

  • Won’t help an infection caused by a virus
  • Won’t get rid of middle ear fluid
  • Can cause side effects
  • Usually don’t relieve pain in the first 24 hours and have only a minimal effect after that
  • Overuse of antibiotics can lead to antibiotic-resistant bacteria, which are much harder to treat.

If a doctor does prescribe antibiotics, a 10-day course is usually recommended. Kids age 6 and older who don’t have a severe infection might take a shortened course for 5 to 7 days. Whatever the recommendation, finish the entire course of treatment! 

Pain medications are the main-stay of comfort care. Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) can help relieve ear pain. Ask your K for Parent doctor for dosing recommendations for your child.

Prevention of Ear Infections

See a doctor in person if…

  • Your child seems ill while on antibiotics
  • Your child has trouble taking liquids
  • The ear drains pus-like fluid or blood
  • The ear pain worsens despite Tylenol or ibuprofen treatment
  • There is swelling and redness behind the ear
  • The ear begins to stick out from the side of the head
  • There is a concern of a foreign object in the ear or hard earwax. 
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Chelsea Johnson, MD, FAAP

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