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).  

Image credit: OpenStax via Wikimedia Commons(external link) 

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 a middle ear infection commonly include: 

• sharp or dull or throbbing pain in ear (this usually wears off within 3 days) 
• feeling of pressure or blockage in your ear 
• discharge from your ear
• headache
• fever (temperature above 38°C)
• reduced hearing in the affected ear or ringing in your ear (tinnitus)
• dizziness or loss of balance.  

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

Middle ear infections are more likely to happen:

• when you have a cold or respiratory infection
• in overcrowded homes
• if you live in a place where you're exposed to tobacco smoke or high levels of air pollution
• if you have seasonal or year-round allergy symptoms
• 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.
• Regular pain relief, eg, paracetamol or ibuprofen can help ease pain and discomfort. 
• Antihistamines and decongestants might provide some symptoms relief but they won't treat the infection itself.

Most middle ear infections in adults can be treated at home. You don't usually need treatment with antibiotics as most will get better without them.

Make an appointment to see your healthcare provider if:

• you have unusual symptoms (eg, numbness of your face or pain in the bone behind your ear)
• your symptoms don’t start to get better after 3 days
• your symptoms last longer than a week.

Antibiotics may be considered for certain situations, eg, severe infections or repeated infections.  

If your infection has cleared but you still have ongoing symptoms (eg, hearing loss) make an appointment to see your healthcare provider.