Ear infection (middle ear) in adults

A middle ear infection is when bacteria or viruses travel from the back of your nose up the eustachian tube. The pressure of the pus can cause the eardrum to burst and pus to leak out, called otorrhoea (runny ear).  

Sometimes, the fluid stays in the middle ear after the infection has gone. This is called ‘glue ear’. Read about glue ear.(external link)  

Some people get ear infections repeatedly, and this can cause hearing problems and other serious complications if not treated.

Symptoms of middle ear infection commonly include: 

• sharp or dull or throbbing pain in ear (this usually wears off within 48 hours) 
• feeling of pressure or blockage in the ear 
• discharge from the ear
• headache
• fever (temperature above 38°C)
• reduced hearing in the affected ear or ringing in the ear (tinnitus)
• dizziness or loss of balance.  

Most symptoms resolve within a week, but it can take 8 to 12 weeks to fully recover.  

Seek advice from your healthcare provider if: 

• you have repeated middle ear infections  
• ear pain is severe 
• you have a fever 
• your face feels numb
• your symptoms don't get better after 48 hours. 

Middle ear infections are more likely to happen: 

• in overcrowded homes 
• if you live in an area of tobacco smoke or high levels or air pollution 
• if you have seasonal or year-round allergy symptoms 
• when you have a cold or upper respiratory infection
• If you work in a place where bugs are easily transferred eg, a day-care centre.

• Rest until you're feeling better. 
• Wipe any discharge from the ear. Don't put anything in your ear.
• A warm or cold flannel can provide comfort.
• Take pain relief if needed.

Pain relief

• Regular pain relief, such as paracetamol(external link) or ibuprofen(external link) can help ease pain and discomfort.  
• Antihistamines and decongestants might provide some symptom relief but they won't treat the infection itself.

Antibiotics  

Middle ear infections don't usually need treatment with antibiotics as most will get better without them. Your healthcare provider may consider antibiotics for certain situations such as severe infections or recurrent infections.  

If your infection has cleared but you still have ongoing symptoms such as hearing loss, contact your healthcare provider.