Acute Bacterial Otitis Media

Key facts

• Acute bacterial otitis media is a bacterial infection of the middle ear, the air-filled space behind the eardrum. It's one of the most common reasons children see a doctor, though adults are affected too.
• Hallmark symptoms are ear pain, a feeling of pressure or fullness, and fever. Young children who can't describe pain may pull at their ears, become irritable, or have trouble sleeping.
• The bacteria most often responsible, Streptococcus pneumoniae and Haemophilus influenzae, reach the middle ear via the Eustachian tube after a cold or upper respiratory infection causes it to swell and trap fluid.
• Most cases are treated with a full course of antibiotics, such as the oral cephalosporin cefdinir.

What drives a middle ear infection

The bacteria most often responsible for acute bacterial otitis media are Streptococcus pneumoniae and Haemophilus influenzae. They typically reach the middle ear via the Eustachian tube, which connects the ear to the back of the throat. A cold or upper respiratory infection can cause this tube to swell and trap fluid, creating conditions where bacteria thrive.

Symptoms

The hallmark symptoms are ear pain, a feeling of pressure or fullness in the ear, and fever. Young children who can't yet describe pain may pull at their ears, become unusually irritable, or have difficulty sleeping.

Antibiotic treatment

Most cases are treated with a course of antibiotics. Oral cephalosporins such as cefdinir are a widely used option, effective against the bacteria most likely to be responsible. Completing the full course matters even once symptoms improve quickly, to prevent recurrence or spread of the infection.

When to see a doctor

Seek medical attention promptly if ear pain is severe, if hearing loss or discharge from the ear develops, or if symptoms don't begin to improve within 48 to 72 hours.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.