Acute Otitis Media
Acute otitis media is a sudden infection or inflammation behind the eardrum, commonly following a cold and causing ear pain, fever and temporary muffled hearing.
Key takeaways
- Viruses and bacteria can produce similar symptoms, and not every episode requires an antibiotic.
- Age, severity, eardrum findings and risk factors guide whether observation or immediate treatment is safer.
- Fluid can remain after the acute illness settles; persistent hearing or speech concerns need follow-up.
The listings below do not establish the cause of ear symptoms; examination should guide treatment.
What clinicians look for
A bulging eardrum with middle-ear fluid supports the diagnosis. Babies may feed poorly, cry more or sleep badly rather than localise the pain. Ear pulling alone is not diagnostic. Discharge can occur if the eardrum perforates and should be assessed.
Relief and antibiotics
Appropriate pain relief is important during the first days. Many uncomplicated cases improve without antibiotics, while severe illness, young age or particular risk factors favour earlier treatment. Antibiotic selection depends on allergy history, recent exposure and local guidance.
When to seek urgent care
Seek prompt care for swelling or redness behind the ear, a protruding ear, facial weakness, severe headache, neck stiffness, marked drowsiness, high fever or a child who appears very unwell.