How Long Does an Ear Infection Last?

Symptoms of an ear infection may occur following respiratory infections such as the common cold, flu, or COVID-19.

There are different types of ear infections, based on where in the ear the infection occurs. 

• Eardrum
• Middle ear (otitis media)

Symptoms of ear infections include:

• Ear pain
• Itching in the ear
• Discharge from the ear (otorrhea)
• Frequently caused by otitis externa (“swimmer’s ear”)
• Hearing loss 
• Often caused by otitis media
• Fullness in the ear
• Ringing in the ear (tinnitus)
• Nausea
• Vomiting 
• Spinning sensation (vertigo)
• Fever 

In children, symptoms of ear infections may also include:

• Pulling on the ear
• Fussiness
• Irritability
• Restless sleep
• Decreased activity
• Decreased appetite or difficulty eating
• Diarrhea

Symptoms of an ear infection may occur following respiratory infections such as the common cold, flu, or COVID-19.

Mild symptoms of ear infections that affect the outer or middle ear are mild usually resolve within one to two weeks. Inner ear infections can last longer. Ear infections lasting 6 weeks or longer are considered chronic ear infections.

Ear infections in the outer canal (otitis externa, or “swimmer’s ear”) is caused by:

• Bacterial or fungal overgrowth in the ear canal that results from moisture mixing with the earwax and debris in the ear canal
• Moisture may enter the ear from swimming, diving, or even bathing and showering
• Overuse of cotton swabs in the ear canal 

Ear infections in the middle ear (otitis media) are caused by:

• Bacteria
• Viruses
• Fluid from the sinuses can back up through the Eustachian tubes that connect the throat to the middle ear, such as when the sinuses or throat are inflamed from infection (from a cold, sinusitis, or an allergy attack) 
• The backed-up fluid becomes trapped in the middle ear, which is a good breeding ground for bacteria and viruses
• Common bacterial causes of middle ear infections are Streptococcus pneumoniae (also called pneumococcus), Haemophilus influenzae, and Moraxella catarrhalis
• Common viral causes of middle ear infections are respiratory syncytial virus (RSV) and flu (influenza) virus

Ear infections are diagnosed with a physical exam. A doctor uses an otoscope (an instrument that is a light with a cone at the tip to visualize inside the ear canal) to check for inflammation in the ear canal. 

Tympanometry may also be performed to check for changes in pressure in the middle ear. 

Medications used to treat ear infection include: 

• Over-the-counter (OTC) pain relievers
  • Acetaminophen (Tylenol) 
  • Ibuprofen (Advil, Motrin) 
• Pseudoephedrine (Sudafed) to ease ear pressure 
• For infections of the ear canal (otitis externa)
  • Neomycin (Ak-Spore HC, Cortisporin, Neotricin HC, Ocutricin-HC), 
  • Polymyxin B
  • Hydrocortisone (Cortisporin, Otocort, Poly Otic)
• For infections of the middle ear (otitis media) and severe infections of the outer ear
• Oral antibiotics 

In cases of a middle ear infection, a doctor may recommend waiting to see if medications such as antibiotics are needed. Home remedies to relieve the symptoms of earache include: 

• Rest
• Drink plenty of fluids
• Decongestants 
• Anti-allergy medications 
• Over-the-counter pain medications such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol)
• Warm compresses applied to the area to help soothe the pain
• Consult your doctor before using over-the-counter pain eardrops. Eardrops should not be used in children with tympanostomy tubes (ear tubes) unless specifically prescribed by a child’s pediatrician. 

Complications of untreated ear infections include:

• Infection spreading to another part of the ear or head: 
• The bones behind the ear (mastoiditis)
• The inner ear (labyrinthitis)
• The protective membranes surrounding the brain and spinal cord (meningitis)
• Permanent hearing loss 
• Paralysis of a nerve in the face

Some ear infections may be prevented by:

• Using earplugs when swimming or diving
• Drying ears thoroughly after swimming 
• Not using cotton swabs inside the ear canal
• Not smoking and avoiding secondhand smoke
• Washing hands thoroughly for at least 20 seconds with soap and warm water to prevent the spread of viruses that can lead to ear infections
• Keeping children up-to-date on immunizations such as the flu vaccine and pneumococcal vaccine, as recommended by a pediatrician 
• Breastfeeding a baby may decrease a child’s chance of getting ear infections