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ENT Conditions and Procedures
Recurrent acute otitis media

 

 

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Recurrent acute otitis media

What is acute otitis media?

This is an infection of the middle ear. The middle ear fills with pus (yellow infected fluid). Your child complains of ear pain and hearing loss. They may have a fever.

The pus comes out of the ear through the eardrum. This relieves the pressure and pain. You will see it as a discharge from your child’s ear. The pus can be stained with blood.

Most ear infections get better on their own. The hole in the eardrum will usually heal on its own.


What is recurrent acute otitis media?

This is a middle ear infection that keeps coming back. Your child has 4 or more middle ear infections in a year.

 4 out of 5 children aged 3 years old will have had an ear infection. Children older than 2 years have a lower risk of having a middle ear infection. The older your child is, the less likely they are to have an ear infection. This is because their eustachian tubes (small tubes that connect the ears to the nose) work better, and they can top up the air inside the middle ear. Their immune system also gets stronger.


What problems can this give my child?

Repeated ear infections can cause other health problems for your child. It can lead to hearing loss, scarring of the eardrum, a discharging ear (for weeks to months) and poor speech development. They may be absent from school a lot. The infection can spread to the mastoid bone or the brain. This is rare.


How is this condition treated?

Treatment options include:

Active observation 

Every episode of acute middle ear infection is treated as it comes. Your child is given painkillers for the first 48 to 72 hours. These can be given as ear drops. If the infection does not settle down in 48 to 72 hours, then your child may be given oral antibiotics.

Longterm antibiotics 

A daily dose of oral antibiotics for 12 weeks can reduce how often your child has an infection. Infections can still occur. These can be treated with a short course of antibiotics.

Grommets 

Grommets are small hollow plastic tubes that create a hole in the eardrum. The operation is done through the ear canal whilst your child is asleep. They can usually go home on the same day.

​​​​​​Grommets allow fluid and pus from the middle ear to come out and air to go in. They reduce the number of ear infections. The grommets usually fall out on their own between 6 and 18 months.

For further information, including the risks, please see Grommets – a decision-making aid for parents


 


Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.


 


 

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Date Published: 06/11/2025 Review Date: 06/11/2028

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