Ear infections are often diagnosed by their symptoms, which include stuffy or runny nose accompanied by sore throat and fever, drainage from the ear, trouble in hearing, and fullness in the ear, accompanied by earache.

To confirm this tentative diagnosis and to ensure treatment, it is important to confirm with a qualified doctor who will examine the eardrum with an otoscope — an instrument used to visualize the inner ear for infections. The doctor will also check for blockage or filling of the middle ear to determine the cause of the earache and infections. Ear infections occur when the middle ear gets filled with mucus, often during a cold, that subsequently gets infected. Symptoms of fever along with earache confirm this diagnosis. However, not all earaches are caused by ear infections; it could be a non-infected buildup of mucous or a referred pain from teeth problems and therefore would make the use of antibiotics unnecessary, as other treatment options need to be explored.
 

Should the doctor suspect a middle ear infection, the goal of treatment will be to curtail and eliminate the infection and restrict further progress of the infection to minimize the possibility of complications. Any swelling in the ear as well as earache will also need to be reduced by providing appropriate treatment. Most ear infections are caused by viruses and therefore treatment need only be symptomatic, to reduce the fever, inflammation, and pain.

Pain relief from the earache can be obtained by acetaminophen, also known as Tylenol. Application of a warm facecloth or heating pad may also provide relief. Cleaning the drainage from the outer ear with a soft tip swab should also be included in the treatment.

Although most infections tend to be viral and therefore do not need antibiotics, some doctors prefer to err on the side of caution and prescribe antibiotics as treatment to cover the possibility that it may be a bacterial infection. Doctors usually go for this treatment when the child is under 2 years old, if the infection is severe or if the earache and infection are not settling in two to three days or if complications develop. Doctors also sometimes prescribe antibiotics to children who are prone to repeated ear infections although experts disagree on the usefulness of such preventive strategies.
 

Amoxicillin is often the antibiotic chosen as treatment to clear up bacterial ear infections. It costs less than other branded medications and serves the purpose. Despite the fact that many doctors will prescribe antibiotics, only 1 out of 5 children actually need antibiotics to clear up an ear infection, whereas in 4 out of 5 it clears up on its own. It is advisable to wait for two to three days to see if the infection is getting better on its own before starting antibiotics because they not only have side effects but also cause resistance to antibiotics as well, as it can lead to antibiotic-resistant strains of bacteria. Side effects include nausea, vomiting, diarrhea, yeast infections, skin rashes, itching, and sometimes, severe allergic reactions.