Quick answer
What is ear infection?
Ear infections are common, especially in children. Middle ear infections (otitis media) often follow a cold and cause earache and fever. Most get better within 3 days without antibiotics. See a GP if pain is severe, symptoms last more than 3 days, or fluid is leaking from the ear.
What is an ear infection?
An ear infection is inflammation caused by bacteria or viruses in the ear. There are different types depending on which part of the ear is affected. Ear infections are very common in young children because their eustachian tubes (which drain the middle ear) are smaller and more horizontal, making it easier for germs to become trapped after a cold.
Most ear infections get better on their own within a few days.
Types of ear infection
Middle ear infection (otitis media) — behind the eardrum. Often follows a cold. Causes earache, fever and temporary hearing loss from fluid build-up. Most common in children.
Outer ear infection (otitis externa) — in the ear canal. Sometimes called “swimmer’s ear.” Causes itching, pain (worse when pulling the ear), and discharge. More common in adults who swim frequently.
Inner ear infection (labyrinthitis) — less common and can cause severe dizziness and balance problems. Needs medical assessment.
Symptoms
Symptoms depend on type and age:
In children:
- pulling or rubbing the ear
- earache — or general irritability in babies
- fever
- difficulty sleeping
- reduced hearing or not responding to sounds
- loss of balance (occasionally)
In adults:
- earache or a feeling of fullness
- muffled hearing
- discharge from the ear (more common with outer ear infection)
- fever
Treatment
Many middle ear infections do not need antibiotics and improve within three days with:
- Pain relief — paracetamol or ibuprofen
- Rest and fluids
- Monitoring — symptoms often peak in the first day or two
A GP may prescribe antibiotics if symptoms are severe, prolonged, or the person is at higher risk. Outer ear infections often need antibiotic ear drops.
Do not insert cotton buds, oil or objects into the ear unless a doctor advises.
Complications
Complications are uncommon but include burst eardrum (usually heals on its own), persistent fluid affecting hearing, or repeated infections. Children with frequent ear infections should be assessed by a GP — grommets may be considered in some cases.
Preventing ear infections
You cannot prevent all ear infections, but:
- keep up to date with childhood vaccinations (including pneumococcal vaccine)
- breastfeed if possible — associated with lower rates in babies
- avoid smoke exposure — passive smoking increases risk
- treat colds promptly and avoid exposure to respiratory infections where possible
When to see a GP
See a GP for earache lasting more than three days, severe pain, discharge from the ear, or repeated infections. For babies under three months with fever, seek advice promptly.
If you are unsure whether earwax is causing the problem rather than infection, see our earwax build-up guide — do not attempt to remove wax if the ear may be infected.
Common questions
- What are the signs of an ear infection in a baby?
- Pulling or rubbing the ear, irritability, difficulty sleeping, fever, not reacting to quiet sounds, being off their food, and loss of balance. Babies cannot tell you their ear hurts — these behaviours are clues.
- Do ear infections need antibiotics?
- Many middle ear infections clear up on their own within a few days. A GP may recommend a wait-and-see approach or prescribe antibiotics if symptoms are severe, last more than a few days, or the person is very young or at higher risk of complications.
- What is the difference between outer and middle ear infection?
- Outer ear infection (otitis externa) affects the ear canal — often causing itching, pain when touching the ear, and sometimes discharge after swimming. Middle ear infection (otitis media) is behind the eardrum — common after a cold, with earache and fever.
- Can ear infections cause hearing loss?
- Temporary muffled hearing is common during a middle ear infection because of fluid behind the eardrum. Hearing usually returns once the infection clears. Persistent hearing problems in children should be checked.
- How can I ease earache at home?
- Paracetamol or ibuprofen for pain and fever (age-appropriate dosing for children), a warm flannel against the ear, and keeping upright can help. Do not put objects, drops or cotton buds in the ear unless a doctor advises.