Children's Health Q&A by Dr. Phillips

Answer:

Anatomy of an Ear Infection Slideshow

While there exist over-the-counter (OTC) remedies and medications that can alleviate the pain and symptoms of an ear infection, there are no OTC measures that kill the bacteria in the middle ear space that actually cause the infection. The "feel better" measures that work the best are oral pain medications like acetaminophen (Tylenol) or oral pain/antiinflammatory medications, like ibuprofen (Advil, Motrin). Topical anesthetic drops are also available that are applied into the ear canal and basically numb the inflamed ear drum from the outside. But since the infection is caused by bacteria in the middle ear space on the other side of the eardrum, nothing applied externally can help kill the bacteria through the intact eardrum.

There are those that say that not all middle ear infections really need antibiotics. Before there were doctors and antibiotics, most middle ear infections did ultimately improve on their own. But a significant percentage of those untreated ear infections did not "go away on their own" and led to serious complications such as progression of the infection to the neighboring mastoid bone (mastoiditis), ruptured ear drums, deafness, and even spread of the infection to the spinal fluid surrounding the brain (meningitis). Given the safety and experience we have with antibiotics today, I think that antibiotics are important tools in treating ear infections, along with the "feel better" medications.

Thank you for your question.