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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Video assessment, with a prescription when appropriate.
- Most middle ear infections settle within about three days without antibiotics; a video call cannot see the eardrum, so the assessment is history-led and honest about when an in-person ear examination is needed.
- After a middle ear infection, muffled hearing can outlast the pain by several weeks while fluid drains from behind the eardrum.
- Swelling or redness behind the ear, an ear pushed outwards, facial weakness or confusion needs same-day in-person care.
- Antibiotics are considered when symptoms are severe, both ears are affected in a young child, or there is discharge.
Online care suits most straightforward ear infections. Get in-person care the same day for redness or swelling behind the ear, an ear that is starting to stick out, new facial weakness, severe headache with a stiff neck, confusion or unusual drowsiness, or a baby under six months with fever. A child who is getting sleepier, floppier or harder to wake needs to be examined, not booked online.
Can an online doctor treat an ear infection?
Often, yes. A structured history plus a look at the outer ear on camera can usually establish whether an ear infection is likely and whether it needs antibiotics or just pain relief; most middle ear infections clear within about three days.[1] A video call cannot see the eardrum, so uncertain or higher-risk cases are sent for in-person examination.
This page covers ear infection as a diagnosis, in both its common forms: middle ear infection (otitis media), which usually follows a cold, and outer ear canal infection (otitis externa), which usually follows water or cotton buds. If you have ear pain and do not yet know why, start with our guide to earache and ear pain, which walks through all the causes, including the ones that are not infections. If the problem is clearly the canal after swimming, the dedicated swimmer’s ear page covers drops and keep-dry care in full, so we keep only a summary here.
Listen: Ear Infection Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with an ear infection
? Photograph what is visible: the outer ear in daylight, the canal entrance, any discharge on a clean tissue, and any redness or swelling around or behind the ear. On the call the doctor looks at the outer ear on camera and, for a child, watches behaviour. No photo can show the eardrum itself, and the doctor never pretends otherwise.
the two infections feel similar but are treated differently, one with pain relief and sometimes oral antibiotics, the other with ear drops. The symptom pattern separates them reliably in most cases.
guideline criteria, not reflex prescribing. Most middle ear infections resolve on their own, so the doctor prescribes when defined markers are present and explains a backup plan when they are not.
your observations are the raw material of the assessment: fever pattern, ear pulling, sleep, drinking, and how your child looks on camera. You leave knowing exactly which changes mean re-assessment.
no online service can perform otoscopy. When the diagnosis genuinely depends on seeing the eardrum, the doctor says so and directs you to an in-person examination instead of guessing.
What the doctor checks in an online ear infection consultation
The assessment is structured around three questions: which part of the ear, does it need antibiotics, and is anything dangerous developing. The doctor will typically assess:
- The story: pain after days of a cold points to the middle ear; itch turning to pain after swimming, humid weather or cotton-bud use points to the canal.
- The tragus test, guided on camera: pain when the small flap in front of the canal is pressed, or when the outer ear is pulled, is typical of canal infection rather than middle ear infection.[3]
- Fever and general state: in children especially, drinking, wet nappies, alertness and how they respond to you matter more than the thermometer reading alone.
- Discharge: sudden relief of pain followed by fluid from the ear suggests the eardrum has perforated, which changes both treatment and follow-up.
- Hearing change: muffled hearing is expected during a middle ear infection; the doctor checks it is recent, one-sided and explained by the infection.
- Risk factors that lower the antibiotic threshold: age under 2 with both ears affected, discharge, significant systemic illness, grommets, diabetes or a weakened immune system.[1]
- The red-flag screen, actively: swelling or redness behind the ear, an ear pushed outwards, facial weakness, stiff neck, drowsiness or confusion.
Is it a middle ear infection or an outer ear infection?
A middle ear infection sits behind the eardrum, usually follows a cold, and causes deep pain, muffled hearing and often fever, most commonly in children. An outer ear infection involves the ear canal itself, usually follows water exposure or scratching, and causes itch, tenderness when the ear is touched, and pain on chewing. The two are treated differently, so the distinction matters.
Otitis media: behind the eardrum
Cold viruses inflame the tube that ventilates the middle ear; trapped fluid becomes infected, pressure builds, and the ear hurts. It is one of the most common childhood infections and much rarer in adults, where a first episode still deserves proper assessment. Most cases settle within about three days with pain relief alone.[2] After the infection, fluid can linger for weeks and muffle hearing before it drains; persistent muffled hearing is covered on our hearing loss page.
Otitis externa: the ear canal
Water, humidity, eczema and cotton buds strip the canal’s protective wax and let bacteria in. The treatment is topical: antibiotic or antiseptic ear drops, not oral antibiotics, plus strict keep-dry care.[3] Because it is so strongly linked to swimming, we cover it in depth on the swimmer’s ear page, including the drops, the technique and the prevention routine that stops the next one.
Do I need antibiotics for an ear infection?
Usually not. Most middle ear infections resolve within about three days with pain relief alone, and antibiotics make little difference to pain for most people while adding side effects and resistance.[5] Doctors reserve them for defined groups: children under 2 with infection in both ears, ear discharge, significant systemic illness, or symptoms not settling.[1] Prescribing thresholds vary slightly by country.
Antibiotics are only prescribed when there are genuine signs of bacterial infection meeting these criteria; they do nothing for the viral infections behind most ear trouble, and every unnecessary course makes resistance worse for everyone. Where the picture is borderline, the doctor can agree a backup prescription: one you activate only if things have not begun to improve after two to three days.[1] You stay covered without taking medicine you probably do not need. Ear canal infections are different again: the antibiotic goes in as drops, reaching the infection directly at far higher concentrations than tablets could.
How long does an ear infection last?
A typical middle ear infection hurts most in the first 24 to 48 hours and settles within about three days, occasionally up to a week.[2] Ear canal infections usually improve within a few days of starting drops, with a full course running 7–14 days. Muffled hearing can outlast the pain by several weeks while fluid drains.
Two timelines deserve respect. Pain worsening after three days despite proper pain relief needs re-assessment, because that is where treatment changes. And an ear still discharging, or hearing still muffled, beyond two to four weeks needs an in-person look at the eardrum to check for persistent perforation or trapped fluid, rather than another course of anything.[2]
Ear infections in children
Children get middle ear infections constantly, for anatomical reasons: their ventilation tubes are shorter and more horizontal, so cold viruses reach the middle ear easily, and nursery supplies the colds. The practical playbook for parents:
- Treat the pain properly: paracetamol or ibuprofen at the weight-appropriate dose on the packet, given regularly rather than only at crisis point, is the treatment that actually changes how the night goes.[1]
- Watch the child, not just the ear: a child who is drinking, playing between grumbles and consolable is reassuring; one who is listless, refusing fluids, or getting worse after day two or three needs review.
- Expect the hearing dip: days to weeks of mild muffling after an infection is common while fluid drains. Mention it at school if it lingers, and have it checked if it has not cleared in around a month.
- Count the episodes: frequent repeat infections, or persistent fluid with hearing difficulty ("glue ear"), are a reason for referral to ear specialists to discuss options such as grommets, because long-running hearing loss can affect speech and learning.[4]
Online care fits childhood ear infections well precisely because most need assessment, pain treatment and safety-netting rather than a procedure. The exceptions are firm: babies under six months, children who look seriously unwell, and any red-flag sign go to in-person care immediately.
Which ear infection treatment might the doctor recommend?
Treatment follows the site of infection and the risk group. This is the decision framework our doctors use, aligned with the cited guidance:[1]
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| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Ear pain during or after a cold, no discharge, otherwise well | Regular paracetamol or ibuprofen; most settle within about three days without antibiotics | Usually yes | Not improving after 2–3 days, worsening pain, or any red-flag sign |
| Child under 2 with both ears affected, ear discharge, or marked systemic illness | Antibiotics often indicated after assessment, alongside pain relief | Often yes; prescribing rules vary by country | Baby under 6 months, dehydration, or a child who looks seriously unwell |
| Itchy, tender ear canal after swimming or cotton buds, pain on pulling the ear | Antibiotic or antiseptic ear drops plus strict keep-dry care | Usually yes | Spreading redness or swelling, severe pain, diabetes or a weakened immune system |
| Discharge after sudden relief of pain (likely perforated eardrum) | Assessment first; some ear drops are unsuitable with a perforation | Case-dependent | Discharge beyond 1–2 weeks, or hearing not recovering: the eardrum needs to be seen |
| Swelling or redness behind the ear, ear pushed forward, facial weakness or stiff neck | Emergency in-person assessment the same day | No | Always; these are signs of a spreading complication |
Availability of individual medicines and who may prescribe them vary by country; your doctor confirms what applies where you are.
Not sure which row is your ear? A doctor can tell you in one consultation. €47, exact price shown before payment.
See available times →Treatment options for ear infections
What you can do yourself
Regular paracetamol or ibuprofen is the evidence-backed first treatment for ear infection pain in adults and children; give it on schedule for the first day or two rather than chasing the pain.[1] A warm flannel against the ear soothes, sleeping with the sore ear upwards helps some people, and swallowing or yawning eases pressure. What not to do matters as much: nothing goes into the ear canal, no cotton buds, no warmed oil for a painful infected ear, and no old leftover drops, which may be the wrong treatment entirely or unsafe if the eardrum has perforated. Decongestants and antihistamines do not speed recovery of middle ear infections and are not recommended for them.[2]
Prescription treatment
A prescription is never issued without a consultation. After assessment, a middle ear infection meeting antibiotic criteria is usually treated with a course of amoxicillin, with alternatives for penicillin allergy; where the case is borderline, a backup prescription to start only if symptoms have not improved in 2–3 days is often the smarter route.[1] Ear canal infections are treated with antibiotic, antiseptic or combination ear drops rather than tablets.[3] Which specific medicines are available, and who may prescribe them, varies from country to country, and the doctor confirms what applies where you are. In pregnancy, ear infections are treated on the same principles with pregnancy-compatible choices, so mention pregnancy or breastfeeding at the start of the consultation.
Flying, swimming and other practical questions
Flying with a middle ear infection is usually possible but can be painful, because a blocked ventilation tube struggles to equalise pressure on descent; swallowing, yawning or gently blowing against a pinched nose helps, and adults can time pain relief for the landing. Diving is different: do not dive with any active ear infection, since the pressure change risks real eardrum damage. Swimming should wait until an ear canal infection has fully settled, and after a perforation the ear must stay dry until the drum has been confirmed healed.
When we treat an ear infection online, and when we refer you
We treat online: typical middle ear infections in adults and children, with a proper pain plan, antibiotic assessment against guideline criteria and clear safety-netting; ear canal infections suitable for drops; backup prescriptions for borderline cases; and reviews when an ear is not following the expected timeline.
We refer or redirect you: babies under six months with fever; any sign of mastoiditis or spreading infection; new facial weakness; suspected perforation that is not healing or discharge beyond two weeks; frequent recurrent infections or glue ear needing an ear, nose and throat opinion; persistent one-sided smelly discharge with hearing loss, which needs specialist examination; and any case where the diagnosis genuinely requires seeing the eardrum. In those cases the consultation buys you a clear, fast route to the right examination, not a guess.
When to get in-person care
Go to urgent in-person care for swelling, redness or tenderness behind the ear, an ear starting to protrude, discharge with high fever in someone who looks very unwell, or ear infection symptoms with severe headache and vomiting. If there is facial drooping, a stiff neck with a rash or light sensitivity, confusion, a seizure, or a child who is floppy or hard to wake, call 112 immediately.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm, often the same day, with the exact price, €47, shown before you pay.
- Speak to a licensed doctor about ear infections: a private video consultation, from anywhere in Europe, with photos uploaded if there is anything visible.
- Leave with your plan the same day: everything agreed on the call, and if treatment is right for you, the prescription follows straight away, sent to a pharmacy near you in most EU countries. If we can’t help you online, you get a full refund.
Frequently asked questions about ear infections
Can an online doctor prescribe antibiotics for an ear infection in Europe?
Yes, after a consultation. A prescription is never issued without one: the doctor assesses your symptoms by video first and prescribes antibiotics only when guideline criteria are met, because most ear infections clear without them. Prescriptions can be sent to a pharmacy near you in most EU countries, and your doctor confirms what applies in your country.
How much does an ear infection consultation cost?
A video consultation costs €47. The exact price is shown before payment, and there is no subscription. If the doctor can’t treat you online, you get a full refund and clear directions to the right care.
How quickly can I speak to a doctor?
Appointments are available daily from 7am to 11pm, often the same day. Ear infections hurt most in the first day or two, so a same-day assessment with a proper pain plan is usually what changes the night ahead.
Can a doctor really assess an ear infection without looking inside the ear?
Often, yes, honestly: the pattern of symptoms, the tragus test guided on camera, fever, discharge and hearing changes give a reliable working diagnosis of an ear infection in most straightforward cases. What a video call cannot do is see the eardrum, so when the diagnosis genuinely depends on that, the doctor says so and directs you to an in-person examination instead of guessing.
Does my child need antibiotics for an ear infection?
Usually not: most childhood middle ear infections settle within about three days with regular paracetamol or ibuprofen. Antibiotics are considered when defined criteria are met, such as infection in both ears under age 2, discharge from the ear, marked general illness, or symptoms that are not settling, and a backup prescription is often used for borderline cases.
What is the difference between an ear infection and swimmer’s ear?
Swimmer’s ear is an ear infection, just in a different place: the ear canal rather than the middle ear. It typically follows water exposure, itches before it hurts, and is tender when the ear is touched or pulled. It is treated with ear drops rather than tablets, and it has its own dedicated page covering drops and keep-dry care in detail.
Can I fly with an ear infection?
Usually yes, but expect pressure pain on descent because the infected ear equalises poorly. Swallowing, yawning, drinking during landing and timed pain relief all help. Do not dive with an active ear infection, and if you have a perforated eardrum, get medical advice before flying and keep the ear dry until it has healed.
- Otitis media (acute): antimicrobial prescribing (NG91), NICE, National Institute for Health and Care Excellence, 2018 (updated 2022).
- Otitis media - acute: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Otitis externa: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Deafness and hearing loss: fact sheet, WHO, World Health Organization, 2025.
- Antibiotics for acute middle ear infection (acute otitis media) in children (Cochrane Review), Cochrane, Cochrane Collaboration, accessed August 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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