Acute Otitis Media

Acute otitis media is a bacterial or viral infection of the middle ear.

Acute otitis media results from infection by viruses or bacteria, often as a complication of the common cold or of allergies. Acute otitis media is more common in children than in adults. Symptoms and treatment are similar in adults and older children (see Section 23, Chapter 276).

The infected ear is painful, with a red, bulging eardrum. Most people with acute otitis media get better on their own. However, because it is hard to predict who will not improve, most doctors treat all people with antibiotics, such as amoxicillin. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain. Decongestants containing phenylephrine may help, and antihistamines are useful for people who have allergies but not for those with colds.

If a person has severe or persistent pain and fever, and the eardrum is bulging, a doctor may perform a myringotomy, in which an opening is made through the eardrum to allow fluid to drain from the middle ear. The opening, which does not affect hearing, usually heals on its own. People who have repeated bouts of otitis media may need to have drainage tubes (tympanostomy tubes) placed in their eardrums (see Section 23, Chapter 276).

See the sidebar When the Ear Aches.