“Do bacterial infections clear up on their own?”

Not all ear infections are bacterial. Fluid in ear could be viral unless it looks red, inflamed, and filled with pus. Viral ear infections can clear in their own.

Good question.
Many bacterial infections are cleared by our own immune defenses, but do not. For example bacterial meningitis progresses to death or terrible disability without antibiotics, and heart infections are not cleared. Some, for example, pimples and soft tissue infections such as boils will resolve when they drain without antibiotics. Ear infections may clear without treatment, but the may cause various complications such as hearing loss. And the pain may linger. Antibiotics help speed along the clearing of infections and prevent complications.

G. Dickinson

Thank you for your question, which is not as simple as asked. There are different types of "bacterial ear infections" some are in the external ear canal- which is what you see when you look at the ear, and other infections behind the ear drum called middle ear. If the ear drum is busted and pus drains into the ear canal this would be a typical sign of a bacterial middle ear infection. Some of these can resolve without antibiotics. Repeated bacterial middle ear infections may require antibiotics as well as determination whether the infection was due to an unusual bacteria, or there are predisposing risk factors in a child for ear infections. This would require specialist consultation and examination of the ear.

They can but treatment should be based on a good ear exam.

Some bacterial infections do, in fact, clear up on their own. Ear infections in children older than 12 are an example of one such condition. These tend to spontaneously clear in most patients. I would consider antibiotic therapy if the child is very sick, has a high fever (>103 Fahrenheit), or has a bulging eardrum that looks like it might burst. Otherwise, watchful waiting is the correct approach.


Randall Fisher, M.D.
Norfolk, VA