Amoxicillin for Ear Infections

Ear infections can sneak up on you when you least expect it, making the simple act of listening a painful ordeal. They can be even more frustrating to deal with if your child’s the one with the infection.

If you notice any lasting pain, discomfort, or fluid leaking from your ear or your child’s ear, an ear infection might be the cause.

This condition is more common among children than adults, with an estimated 30 million children visiting pediatricians each year for treatment. The good news is that ear infections are treatable with antibiotics and other over-the-counter (OTC) medications.

In this article, we’ll be looking at amoxicillin for treating ear infections, including who should use it, potential risks, and alternative treatments.

What is Amoxicillin?

Amoxicillin is an antibiotic used to treat various bacterial infections, but it’s not effective against viruses, fungi, or parasites.

Like all the other penicillin antibiotics, amoxicillin works by disrupting the growth of bacterial cell walls.

While amoxicillin is used to treat many bacterial infections involving various body parts, some bacteria have developed resistance to it by producing substances that inactivate the penicillin, rendering it ineffective.

In these cases, a single tablet containing a combination of amoxicillin and clavulanic acid may be administered. Clavulanic acid doesn’t kill bacteria, but rather disables the bacteria’s resistance to amoxicillin, making the antibiotic more effective.

We call this combination medication co-amoxiclav (Augmentin®).

What is an Ear Infection?

Ear infections occur when parasites or microorganisms such as bacteria, fungi, or viruses invade the tissues in the ear and cause symptoms of illness.

Bacteria and other microorganisms are naturally found in various parts of the body and they do not always cause disease.

These microorganisms are called commensals, and we have trillions of them. Commensals actually help prevent infections.

Infections are typically caused by harmful microorganisms. The following viruses and bacteria are known to cause ear infections:

• Viruses: Respiratory syncytial virus, rhinovirus, adenovirus, parainfluenza virus, and coronavirus.
• Bacteria: Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae.

What are the Different Types of Ear Infections?

In order to get the proper treatment for your ear infection, you’ll first need to identify which type of ear infection you have. The three main types are outlined below.

Middle ear infection

Also known as otitis media (OM), middle ear infections occur when bacteria or other germs invade the area behind the eardrum.

This area, known as the middle ear, includes the sound-conducting bones of the ear (malleus, incus, and stapes) and the eustachian tube (which connects the middle ear to the throat).

After a viral infection — like the “flu” — the structures in the throat and the eustachian tube can become inflamed. This inflammation can spread up to the middle ear and cause swelling.

The ear’s drainage path gets blocked, causing fluid to build up and create a breeding ground for infections.

This is why we often develop ear infections after getting sick with viral infections.

Otitis media with effusion (OME)

When an infection starts in the middle ear, the immune system sends cells to the infected area. These cells increase swelling and redness.

The swelling blocks the ear's normal fluid drainage and leads to immune cells fighting and dying along with the germs — which results in a large amount of fluid containing dead, living cells and germs.

When this fluid is present behind the eardrum, it’s called otitis media with effusion (the effusion is the fluid behind the eardrum).

The fluid causes pressure in the ear that can’t be equalized because the middle ear is now blocked off from the outside. Increased ear pressure contributes to the pain and blocked sensation commonly associated with an ear infection.

In some cases, the eardrum separating the middle ear from the outer ear can rupture, causing the fluid inside the ear to leak out.

This is called otorrhea and it usually requires a visit to an ear, nose, and throat (ENT) doctor.

Otitis externa (swimmer’s ear)

This is an infection of the outer ear that extends from the visible part of the ear to the eardrum. This type of infection is not usually caused by the same type of germs as other ear infections.

Typically, bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus — both normally dangerous bugs that are often resistant to regular antibiotics like amoxicillin — are responsible.

It is believed that loss of protective factors – such as ear wax and acidic pH in the ear – cause bacterial overgrowth and infection.

The most common risk factor for developing otitis externa is swimming, hence its other name, swimmer’s ear.

Swimmer’s ear affects 1 in every 200 Americans every year, and swimmers and surfers are among those most at risk.

Other risk factors for swimmer’s ear include humidity, injury to the ear, foreign objects in the ear, and a compromised immune system.

Symptoms of otitis externa include:

• Ear pain
• Discomfort or itching
• Fluid draining from the ear
• Swelling
• Redness
• Fever

Is Amoxicillin an Effective Treatment for Ear Infections

Amoxicillin or co-amoxiclav is typically used as a first-line treatment for otitis media. For otitis externa, amoxicillin is not the treatment of choice, as most of the organisms causing this infection are resistant to it.

Oflaxacin, ciprofloxacin, or polymyxin B are typically administered in the form of ear drops to treat otitis externa. Pain medication may also be used to manage the symptoms.

Symptoms should improve within 48 hours after starting treatment.

How Do I Use Amoxicillin to Treat an Ear Infection?

To treat otitis media, adults are usually administered 500 mg of amoxicillin twice per day, but this can be increased to three times a day for more severe ear infections.

Children, however, are given medication depending on their weight. The pediatric dose of amoxicillin is 25–45 mg/kg, divided into multiple doses throughout the day. Keep in mind that this dose does not exceed the adult dose, even if the child’s weight indicates a higher dose.

Both adults and children are treated for 10–14 days. Always follow your healthcare provider's instructions when using antibiotics.

What should I do if I miss a dose of amoxicillin?

You shouldn't stop taking amoxicillin or miss doses, even if you begin to feel better before finishing the entire course. If you forget a dose, do one of the following:

• If it's almost time for your next scheduled dose when you realize you've missed one, just skip the missed dose and continue with your regular schedule.

OR

• If there's ample time before your next scheduled dose, take the missed dose.

Avoid doubling up on doses. Dispose of any unused antibiotics responsibly and refrain from sharing antibiotics or storing them for future use.

You should always contact your doctor for advice prior to modifying treatments, especially when it concerns children.

What are First-Line Treatments for Ear Infections?

Unless you’re experiencing severe symptoms, it is okay to practice watchful waiting if you — or your child — has a suspected ear infection. There’s a great chance that an ear infection can resolve without antibiotic treatment.

Here are some options you may want to try if your symptoms do not clear on their own.

Pain medication

Some common OTC pain medications used to treat the pain and inflammation associated with ear infections include acetaminophen (Tylenol®) and nonsteroidal anti-inflammatory drugs, such as ibuprofen.

While pain medications can provide relief for ear pain, remember that they won’t treat the underlying cause of your ear infection — but the treatments listed below can.

Treatment for otitis media

Either amoxicillin or co-amoxiclav can be used as the first-line treatment for otitis media. If you’re allergic to penicillin, clindamycin or azithromycin may be used.

Treatment for otitis externa

Ciprofloxacin, ofloxacin, and polymyxin B can be used in drop form. Often, steroid drops (like hydrocortisone) are also used.

Acetic acid is a good treatment option if the ear canal is severely swollen and medication cannot penetrate it.

Alternative treatment needs to be discussed with your doctor at consultations.

Can an Ear Infection Go Away on its Own?

Some ear infections are viral and will disappear on their own. Your doctor will use their discretion to decide whether or not you need treatment.

If you suspect your child has an ear infection, it is especially important to consult with your doctor.

When Should You Visit a Doctor for an Ear Infection?

Generally, you should always see your doctor for an ear infection even if you suspect that it is a viral infection.

Because you cannot see inside your own ear, you cannot decide whether you need treatment or not. If you experience any of the following, visit your doctor:

• Pain or other symptoms that do not resolve with OTC medication
• Symptoms outside of your ear — this could indicate more severe illness, especially if you have a fever, too
• Hearing loss, swelling, a rash behind the ear, or fluid leaking from the ear

Where Can I Learn More About Amoxicillin and Other Treatments for Ear Infections?

Do you have ear pain that won’t go away, no matter what medication you take? You may have an ear infection.

Contact LifeMD to find out more about using amoxicillin and other treatments.

Book your appointment today.

A licensed medical professional can answer all your questions regarding antibiotic treatments and potential side effects.

If you are experiencing severe pain or have recently had multiple ear infections, be sure to seek emergency medical help immediately.