Stephen J. Schueler, M.D.

Infected Middle Ear Home Care

Home care for otitis media includes:

Infected Middle Ear Congestion in Adults

Home treatment measures for congestion with otitis media in adults include general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Blow your nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist. Saline may be used to flush the nasal passages:
    • Lie on your back and tilt your head back.
    • Apply 2- 4 drops of saline in one on nostril, then wait 1 minute.
    • Blow your nose.
    • Repeat in the other nostril.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for adults and adolescents.

Precautions include:

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin) can relieve congestion faster than oral medications.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines
Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue.

Examples include:

Precautions include:

Infected Middle Ear Congestion in Children

Home treatment measures for congestion with otitis media in children include general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Ask your child to blow the nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for children more than 6 years old. Talk to your doctor before providing a decongestant to a child less than 6 years old.

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin), can relieve congestion faster than oral medications, but should not be used in children less than 12 years old.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines
Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue. Antihistamines are safe for children more than 5 years old. Talk to your doctor before providing an antihistamine to a child less than 5 years old.

Examples include:

Precautions include:

Diphenhydramine Dosing Chart
AgeDoseIntervalMax Daily Dose
2-5 years6.25 mg4-6 hours37.5 mg/day
6-11 years12.5-25 mg4-6 hours150 mg/day
12 and older25-50 mg4-6 hours300 mg/day

Chlorpheniramine Dosing Chart
AgeDoseIntervalMax Daily Dose
Under 6consult your physician
6-11 years2 mg4-6 hours12 mg/day
12 and up4 mg4-6 hours24 mg/day

Infected Middle Ear Pain and Fever Adults

Medications commonly used to control pain and fever in adults with otitis media include:


Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.

Aspirin

Ibuprofen

Naproxen

Ketoprofen

NSAID Precautions

Infected Middle Ear Pain and Fever Children

Common medications used at home for pain and fever in children with otitis media include:


Aspirin and most of the other nonsteroidal anti-inflammatory drugs (NSAIDS) are not used in children except under a doctor's care.

Acetaminophen
  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Dosing is 10-15 mg per kilogram (5-7 mg per pound) of body weight every 4-6 hours, up to the adult dose.
  • Do not exceed the maximum daily dose.
  • Acetaminophen products come in various strengths. Always follow the package instructions.
  • Avoid this drug in children with liver disease or an allergy to acetaminophen.
  • Common acetaminophen products include Tylenol, Panadol and many others.

Ibuprofen
Always follow the package instructions.

Naproxen

Infected Middle Ear Vomiting in Adults

Home care for vomiting in adults with otitis media includes:

  • Drink clear liquids only, such as water, sports drinks, fruit juice and dilute tea. Sports drinks are best.
  • Drink small quantities of fluids frequently. In general, two tablespoons of fluid every 5 minutes is an effective strategy.
  • Avoid milk and dairy products for 3 days.
  • Avoid liquids that irritate the stomach, such as citrus juice, alcohol and coffee.
  • If nausea or vomiting continues despite the above, consider one of the nonprescription medicines listed below.
  • Once vomiting and nausea resolves, start bland foods first. If you tolerate bland food, then you can resume a normal diet.

Nonprescription medications for vomiting include:

Infected Middle Ear Vomiting in Children

Home treatment of vomiting in children with otitis media includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Infected Middle Ear Warning Signs

Notify your doctor if you have ear pain or otitis media and any of the following:

Continue to Infected Middle Ear Prevention

Last Updated: Dec 22, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Infected Middle Ear References
  1. Aronovitz GH. Antimicrobial therapy of acute otitis media: review of treatment recommendations. Clin Ther. 2000 Jan;22(1):29-39. [10688388]
  2. Asher E, Leibovitz E, Press J, Greenberg D, Bilenko N, Reuveni H. Accuracy of acute otitis media diagnosis in community and hospital settings. Acta Paediatr. 2005 Apr;94(4):423-8. [16092455]
  3. Butler CC, van der Linden MK, MacMillan HL, van der Wouden JC. Should children be screened to undergo early treatment for otitis media with effusion? A systematic review of randomized trials. Child Care Health Dev. 2003 Nov;29(6):425-32. [14616899]
  4. Pappas DE, Owen Hendley J. Otitis media. A scholarly review of the evidence. Minerva Pediatr. 2003 Oct;55(5):407-14. [14608264]
FreeMD is provided for information purposes only and should not be used as a substitute for evaluation and treatment by a physician. Please review our terms of use.