Ear Infection: How Long Does It Take for Antibiotics to Start Working?

Updated on April 28, 2010
C.G. asks from Billings, MT
10 answers

My 14 month old started Antibiotics 2 days ago for his first ear infection. His fever is 103 - 104. As long as we're alternating Motrin/Tylenol every 3 hours his fever stays down, however, as soon as we let it wear off it's back up to 103 degrees. Shouldn't the fever be breaking by now, after 2 days of antibiotics? Or does it take longer for antibiotics to start working?

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So What Happened?

Our little guy's high fever finally broke on the afternoon of day 3 of the Amoxicillin. He's now on the up and up! Thanks so much for all the info!

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answers from Denver on

Something different to consider. Both of my sons have only had like 3 ear infections between them, but all 3 times the culprit was a yeast infection in their ears. If I had given anti-biotics it would've just made the ear infection worse. I used Wish Garden ear drops. Also, unless the fever gets to 104 you should not lower it. It is the bodies way of fighting the infection and you are just prolonging the illness by making the fever go down.
Good luck!

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answers from Denver on

Hi C.,

I'm not sure about the anitbiotics but I do know that a trip to our Chiropractor always takes care of an ear infection for my kids. At the first signs, I run them over there and it's better by the next day. If you have a Chiropractor give them a call and they can help. If not, here is the # to mine. He is located in Northglenn, about I-25 and 104th.
Dr. Arvay ###-###-####
Hope your little one feels better soon!



answers from Seattle on

The fever should break within 48 hours of starting the antibiotic.
Unfortunately abx are grossly overprescribed and most ear infections are NOT caused by bacteria, but by viral infections on which the antibiotic has NO effect at all.
Then, because they are so frequently overprescribed, the small percentage that is typically caused by bacterial infections, might now have involvement of resistant strains, against which the first line antibiotics do no longer work.

My daughter went for 8 or 10 rounds of antibiotics for ear infections in an 8 month period around her first birthday - until we traveled abroad for a vacation and got her checked out there. The doctor (a regular pediatric doctor in Europe) was horrified to hear the treatment regimen and prescribed a mucolytic and medicated nosedrops to reduce the swelling in her sinuses and help the fluid drain from her ears. They do NOT routinely prescribe abx unless it is absolutely necessary.

My personal experience leads me to believe that US doctors may not have the latest information that is internationally available for the treatment of ear infections in infants... in addition the drugs we were prescribed are not available in infant doses in the US... really quite sad.
We brought an ample supply and will refill (these are OTC meds) when we go back. I usually give my daughter just one dose of nosedrops and mucolytic when she gets nasal congestion and that has really kept it at bay. We cleared this with our US pediatrician by the way, who agreed that it was ok.

We had been talking about getting tubes after our return from vacation, but after being treated in Europe my daughter's ear infections did not return. It's been more than one year now.

Unfortunately getting a second opinion will not help very much, since abx is the standard treatment in the US. You may want to consult an ND for alternatives...
Good luck!



answers from Denver on

I have a son, who thankfully does not get ear infections often, but when he does, it takes a few days for the antibiotics to work. In January he had one of those with a fever over 104. We took him in on a Thursday, and I think the fever was gone by Sunday or Monday. I do remember it was not gone soon enough for him to go to Sunday School on Sunday. On that Friday, he saw his specialist and she agreed with the treatment and said it would take a while since the fever was so high. By Monday, you never would have known he had been so sick. GL! I hope he feels better soon, and the fever leaves soon. I agree with the post that said it's normally 24 hours, but I have also experienced that that's not alway the case. Maybe a resistant strain?



answers from Topeka on

The fever is helping fight the infection and what is going on in his body the antibiotics are killing off the bacteria for the ear infection so a fever may last for another 24 hrs before it starts to go down or completly goes away is he teething this will also cause fevers in children.You'll see a change in fevers soon



answers from Salt Lake City on

I am not a big fan of antibiotics. Try to lower the temperature naturally if possible and also take him to a chiropractor. I think that is your best option for your baby



answers from Denver on

Dana W has it right here. Could be the antibiotic is not working and you need to move on to something stronger. We went from amox to amox/clav combo, but I'm sure your pedi knows best. Good luck.



answers from Indianapolis on

It depends on which antibiotic was prescribed, but generally, they are working within 48 hours.

It sounds as if this antibiotic may not have taken its full effect yet or isn't the right one for his ear infection.

My guess, based upon guidelines both from the American Academy of Otolaryngology and the American Academy of Pediatrics is that it's amoxicillin. Our daughter just turned 2 and just had her 10th diagnosed ear infection - she's scheduled for round 2 of tubes next Monday, so we know this well.

Generally 1st ear infection - amoxicillin (now a weaker antibiotic)
2nd ear infection - Augmentin (slightly more powerful antibiotic)
3rd ear infection - Omnicef (more powerful antibiotic)
4-5th ear infections - tubes

I'd call the pediatrician's office since the fever is continuing to be elevated. It could also be concurrent bacterial ear infection and some kind of virus making the fever an issue.

Regardless, your pediatrician should likely be called to alert them and see what they suggest.

Good luck. I hope he's well soon.



answers from Billings on

My husband is a pediatrician, and has given trainings on how to tell a viral from bacterial ear infection. Most ear infections are caused by viruses, not bacteria, so antibiotics don't actually stop them. The fact that they aren't working for your son is a clue that you're dealing with a virus. It usually takes the body 2-7 days to fight off a virus (so sometimes it seems like antibiotics help... another reason they get over perscribed!) Keep giving motrin/tylenol, and plenty of fluids and rest. Also a warm pack over the ear can be comforting (I filled a sock with rice and a teaspoon of dry herbs like marjoram and lavender, just to smell nice, dampen the sock with water and microwave for a minute to warm it up). Do keep giving your son antibiotics though until they are gone since they were started. And call your doctor if he's not getting better in another day or so. Good luck! They are painful!!



answers from St. Louis on

i am a medical asst it only takes 24 hours for the meds to start working just make all of the med is taken. good luck.

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