Ear-Nose and Throat Doctor (ENT) Questions ear infection

Why was I prescribed an antibiotic for an ear infection? Don't I need drops?

I was prescribed a round of antibiotics for an ear infection...should I take it? I've had several ear infections but have never been prescribed an antibiotic before. I'm nervous that these were given to me "just to be safe" and won't actually help my infection. What can I do?

7 Answers

Ototopical antibiotics are usually prescribed for external ear infections or dermatological conditions. External ear infections are also known as swimmers ear and indicates a painful swelling of the ear canal skin. Acute otitis media is the classic ear infection more common in children where you get pus and fluid behind the ear drum. This is best treated with oral antibiotics. Rarely an acute otitis media can rupture an ear drum leading to drainage that should be treated with drops. So, depending on the type of ear infection, oral antibiotics, and/or drops are appropriate. Hope this helps.

Eric M. Gessler, M.D.
Most ear canal infections can be treated by microscopic debridement of debris and other purulent/particulate matter in the ear canal. And topical application of an acidifying agent (e.g. Vosol). Antibiotic drops will suffice in most cases, being Rx'd for 5-10 days. Some ear canals need to be reclined after a week. Oral antibiotics are seldom indicated unless is also a middle ear infection, Post traumatic, contaminated TM perforation, extensive auricular involvement, immune compromise, some brittle diabetics. More can to find non-ENTs who Rx oral antibiotics for uncomplicated ear canal infections.
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It’s a legitimate concern. Ear infections are notoriously mis- (and over) diagnosed. It’s also impossible to say without a proper exam. Most antibiotics carry little risk, however. Either make a choice or get a second opinion.
An ear infection can be either an external ear canal infection or a middle ear infection...the canal infection, you treat with drops...the middle ear infection, you treat with antibiotic...the eardrum separates the ear canal from the middle ear...and ear pain can be the same for both.
If you have a bacterial middle ear infection, you will need the antibiotics to help fight the infection. Ear drops are for an infection of the ear canal which is a different infection than one in the middle ear (where the tiny bones for hearing are). Some patients have tubes in the ear or a perforation (hole) in the ear drum and then ear drops can be effective in helping to cure a middle ear infection because the antibiotics in the drops reach the middle ear. For the majority of people with an intact ear drum, ear drops do not help a middle ear infection because they can not reach the middle ear! It's always best to clarify from your doctor if you have a middle ear or ear canal infection.
Unless you have drainage or a hole in your ear drum or an ear tube, or an
outer ear infection, you don't need drops for a middle ear infection. They
can't get to your middle ear without an opening in your ear drum so they
wouldn't typically help.
It depends on type and location of ear infection.  Outer ear infections are treated with drops, middle ear infections are treated with pills.