Antibiotic for Ear Infection: What Works, What to Avoid

When it comes to an antibiotic for ear infection, a medication prescribed to treat bacterial infections in the middle ear. Also known as otitis media treatment, it’s one of the most common prescriptions for kids—and often completely unnecessary. Many ear infections, especially in older children and adults, clear up on their own. But when bacteria are the real culprit, picking the right antibiotic, a drug designed to kill or stop the growth of bacteria makes all the difference.

Not every ear infection is the same. Some are viral, some are bacterial, and some are just fluid buildup with no infection at all. Doctors look at symptoms like fever, ear pain lasting more than 48 hours, fluid draining from the ear, or if the child is under two years old. If they suspect bacteria, they’ll usually start with amoxicillin, a first-line antibiotic often used for ear infections because it’s effective, affordable, and well-tolerated. It’s the go-to because it works against the most common bugs like Streptococcus pneumoniae and Haemophilus influenzae. But if you’ve taken it before and it didn’t help, or if you’re allergic to penicillin, doctors might switch to azithromycin, a macrolide antibiotic that’s taken for fewer days and easier on the stomach. It’s not always better—it’s just different.

Why does this matter? Because overusing antibiotics leads to resistance. That means the next time you really need one, it might not work. That’s why many doctors now wait 48 to 72 hours before prescribing—especially for older kids with mild symptoms. Pain relief with ibuprofen or ear drops can be enough to get through the worst of it. If the pain doesn’t improve, or if you see pus or hearing loss, that’s when antibiotics become necessary.

You’ll find posts here that break down exactly how these drugs compare, when they’re truly needed, and what alternatives exist. Some people wonder if home remedies work—others want to know how to buy generic versions safely. There are guides on what to do if your child keeps getting ear infections, and how to tell if it’s an ear infection at all versus something else. You’ll also see real comparisons between common antibiotics like amoxicillin and azithromycin, and how they stack up against older options like cefdinir or ciprofloxacin ear drops. No fluff. Just what works, what doesn’t, and what to ask your doctor next time you’re handed a prescription.