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Otitis Media (Acute)

By Richard T. Miyamoto, MD, MS

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 among children than adults (see see page Acute Middle Ear Infection in Children). Symptoms and treatment are similar in adults and older children.

The infected ear is painful, with a red, bulging eardrum. Most people with acute otitis media get better without treatment. However, because it is hard to predict whose symptoms will not lessen, some doctors treat all people with antibiotics, such as amoxicillin. Other doctors give antibiotics only if the illness is severe or if symptoms do not lessen after 72 hours. Pain relief is important. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain. Decongestants containing phenylephrine may help adults (but not children), 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 without treatment. People who have repeated bouts of otitis media may need to have drainage tubes (tympanostomy tubes) placed in their eardrums (see see Figure: Myringotomy: Treating Recurring Ear Infections).

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