Ear infection antibiotics – when a clinician decides
Why ear pain does not always need antibiotics, what an examination can show and when an ear infection needs urgent care.
Ear pain has more than one cause
Ear pain can come from an outer-ear infection, a middle-ear infection, wax, injury, a blocked nose, teeth or jaw problems. Antibiotics are not automatically needed, and the correct treatment depends on which part is affected, the person's age, severity and examination findings.
Why an ear examination matters
- The eardrum and ear canal can need different treatment.
- Discharge, hearing loss, fever or swelling can change the urgency.
- A perforated eardrum affects which drops are safe.
- Repeated infections or symptoms that do not improve need a review rather than repeated leftover medicine.
Do not put oils, cotton buds or unprescribed drops into a painful ear, and do not use someone else's antibiotic.
What to do before the appointment
- Note when the pain started and whether there is fever, discharge or reduced hearing.
- Keep water out of the ear if the clinician has advised this.
- Ask a pharmacist about age-appropriate pain relief.
- Take all current medicine information to the appointment.
Some ear symptoms need same-day care
Common questions
- Do ear infections always need antibiotics?
- No. The cause and part of the ear involved determine treatment. A clinician or pharmacist should assess the symptoms and the person's risk.
- Can I use old ear drops for a new ear infection?
- No. The drops may be wrong for the cause or unsafe if the eardrum is perforated. Get product-specific advice.
Sources
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
Last reviewed 26 August 2026.