What are the Pros and Cons of Antibiotics for Ear Infections?

Antibiotics for ear infections can help clear up an ear infection and reduce the risk of complications, but there are some cons to consider when deciding if antibiotics are appropriate. The standard of care for ear infections generally recommends no antibiotics and a watchful waiting approach except in some specific cases, as many ear infections clear up without medical intervention. Patients can discuss treatment options with a general physician or ear, nose, and throat doctor and people with a history of recurrent infections may want to explore more aggressive treatments.

The benefit to using antibiotics for ear infections is that a course of antibiotics can clear up an infection more quickly than the body can on its own. In addition, using antibiotics reduces the risk of rare complications like the spread of infection to the bone. Patients may feel more comfortable with antibiotics and mild analgesics, and will be able to return to regular activity levels soon after starting treatment.

One obvious con to using antibiotics for ear infections is that not all ear infections are caused by bacteria. If an infection is viral, antibiotics will have no impact on the organisms causing the infection. Moreover, every time people take antibiotics, they can contribute to the development of antibiotic resistance, making those medications less effective in the future. In addition, long term antibiotic usage and chronic use of antibiotics can damage populations of bacteria in the gut, in addition to making the immune system less effective, two issues that can have future consequences.

Using a mild generic antibiotic to improve healing time for an ear infection can be beneficial, although patients may want to wait and see if the infection starts to clear on its own within two to three days. Very strong antibiotics for ear infections should be avoided. Even though they are preferred because the course of medication is shorter, the tradeoff is the risk of developing antibiotic resistance and making these stronger medications unavailable in the future.

For certain patients, antibiotics for ear infections may be recommended right away, without waiting to see how the infection progresses. Immunocompromised patients cannot fight off infections on their own and need medications to recover from ear infections. Likewise, people with certain medical conditions can be at increased risk of complications from ear infections, making antibiotic usage prudent and advisable. Patients who have repeat ear infections, like four or more in a year, may need additional screening to look for potential causes and explore other treatment options, like the placement of tubes for drainage to prevent the ears from becoming infected.