Children’s Earaches: Medicate? Or Watch and Wait?

When your child has an earache, your first thought may be to ask your doctor to prescribe an antibiotic. That could be a mistake. If the problem results from an infection caused by a virus, an antibiotic won’t help. Moreover, although antibiotics are effective against bacteria, their overuse and misuse leads to the development of drug-resistant super bugs. This makes future infections harder to treat.

Ear infections are common in early childhood. They’re not contagious, but often occur as side effects of contagious illnesses—colds, coughs, or eye ailments like pinkeye. For example, a stopped-up nose can block the Eustachian tube, a tiny tube connecting the middle ear to the back of the throat and nose. This causes a fluid buildup that presses on the eardrum. Problems of this kind often clear up with little or no treatment if the body’s own infection-fighting mechanisms are given time to work.

Whether you call on a doctor at all should depend on the severity of your child’s symptoms.


Contact your physician if your child has the following symptoms:

  • High or persistent fever
  • Serious pain
  • Excessive drowsiness
  • Difficulty in attracting the child’s attention

Because these symptoms are hard to assess in infants and very young children, erring on the side of caution makes sense if your child is under age two. If your child’s ear needs to be drained, your pediatrician may refer you to a specialist in addition to prescribing medication.

Watch and wait

Watching and waiting is useful when it is uncertain that the child has an acute ear infection because the ear drum is not visible to the physician and when a child is more than two years old.

Under these conditions, taking a non-aspirin pain reliever like acetaminophen or Tylenol instead of antibiotics can be the wiser course for the child’s long-term health, not to mention saving you money.

This does not apply to children older than two years with severe acute ear infection or any child less than two years old with acute ear infection. If your pediatrician does recommend antibiotics, discuss a five-day series rather than 10.

Important tips

Once your child begins taking any antibiotic, use the full prescription as directed, even if all pain and fever go away within hours. If antibiotics are stopped early, any surviving bacteria may develop resistance to the medication.

Never give someone an antibiotic prescribed for a previous illness, much less a medication prescribed for someone else. If you have any leftover antibiotics in your medicine cabinet, throw them away.

Other preventive measures

  • Teach children to wash their hands well
  • Remind children to cover their mouths with tissue when they cough or blow their noses
  • Wash toys well after use

For more information, visit the Fluid in the Middle Ear: A Guide for Parents
This Q&A; explains the main kinds of ear infections found in children and when it’s necessary to use antibiotics.