Alarm symptoms

​​Ear infections in children are very common but unfortunately, very distressing also. Your child is almost certainly going to have some form of ear pain before the age of five and more likely 1-2X/year up to that age.

Ear infections may occur alone or as part of a minor illness with temperature, headache and tummy pains. Your first step with a child in pain/discomfort is to try and ease it with either

Paracetamol for children (a common brand is Calpol but others are equal)
or ibuprofen* for children (a common brand is Nurofen* but others are equal).

You should use the dose and frequency according to box instructions, as this varies depending on the strength you buy and your child’s age. If necessary you can combine these medications. As long as your child does not have any ‘ALARM SYMPTOMS’ then you should treat for 48 hour. If your child is not improving at this time you should consult a doctor. If this is when the surgery is closed follow the out-of hours guidance. 

You do not need to see a doctor for these medicines as they are very cheap to buy at chemists, supermarkets, corner shops and even petrol stations. If the cost (about £1-2) is a problem you can see your pharmacist under the pharmacy first scheme and get free medication. 

As described above, ear infections (as with other childhood illnesses) can be isolated or part of a general illness.

Some features that should prompt early or immediate review are:

  • A purple/red rash (often developing rapidly) that does disappear when a glass is pressed against it see meningitis section
  • Loss of consciousness or difficult to rouse from sleep. 
  • A persistent temperature over 39 degrees that fails to come down after both medications above given* 


​Ear infections in adult often take a different form, involving the external ear canal and not inside. If you start with ear pain then, as for children, treat it with painkillers for 48 hours. If not settling by 48 hr see a G.P.

If there is discharge at any time you should arrange review within 48 hours. Ear pain is not always infections and may be associated with impacted wax, when it is often associated with hearing loss.

Ear Infections