Acute middle ear infection usually clears up completely with antibiotic drugs, although sometimes there may be continual production of a sticky fluid in the middle ear known as "persistent middle ear infection." A doctor may also remove pus and skin debris and prescribe antibiotic ear drops. Ephedrine nose drops can help establish draining of the ear in children.

Since the mid-1980s, some strains of bacteria have developed resistance to amoxicillin and other antibiotics. Some children may not improve after 10 days of antibiotics and may need three or four more weeks of drug treatment.

Acetaminophen may be given to relieve pain or to reduce fevers above 101°F. A warm towel or hot water bottle over the sore ear, or an ice pack wrapped in a towel, may ease pain. The child should lie with the infected ear down to help drain the fluid.

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