Otitis media, more commonly known as an ear infection, may or may not require antibiotics, depending on the source of the apparent “infection.” Otitis media 
with effusion (OME) occurs when there is a buildup of fluid in the middle ear without signs of infection such as pain, redness, pus, or fever. The most common causes of that fluid buildup include allergies, irritants such as certain chemicals or cigarette smoke, and changes in air pressure due to airplane travel.
Acute otitis media on the other hand is a true infection and may be caused by either a bacteria or virus.
Risk Factors. Children under the age of 2 and exposure to air pollution or cigarette smoke are the greatest risk factors for an ear infection.
Symptoms. Particularly with children, the most common symptoms of an ear infection include pulling at the ears; excessive crying; fluid draining from the ears; sleep disturbances; fever; headache; temporary hearing loss; irritability; and difficulty with balance.
When to seek Medical Care. Visit your doctor or local urgent care clinic if you experience a temperature >100 degrees, blood or pus in the ears, or symptoms that have not improved within a few days.
Treatment. Most ear infections will heal on their own. Tylenol and other OTC pain relievers can be used to treat associated pain and fever. Antibiotics such as amoxicillin will be needed for those infections truly caused by bacteria.
