Most middle ear infections will resolve on their own, without antibiotics. A healthy, older child may be treated with pain killers and close followup.
Antibiotics can be given if the symptoms are severe, persist, or worsen. Antibiotics may also be given to children who are young or at risk for complications to help resolve the infection, reduce pain and prevent complications. Once antibiotics are given, the fever and pain should improve or resolve within 48 to 72 hours.
Painless fluid in the middle ear may last for a few weeks or months after an acute infection. It may be necessary to drain the fluid if it fails to drain by itself.
Symptomatic relief of upper respiratory infection symptoms (running nose, blocked nose) with antihistamines or nasal decongestants may be given.
Complications such as acute mastoiditis, meningitis and brain abscess arising from middle ear infection are now rare because of antibiotics usage.