Many ear infections will get better on their own, with or without antibiotics. One problem with "watchful waiting" is that ear infections can really hurt -- especially at night. An article in the May 2001 issue of Infectious Diseases in Children has a suggestion for when a physician has examined a child's ear and decided that it is safe to wait 48 hours to see whether the ear infection is likely to improve without antibiotics: prescribing topical anesthetic ear drops to erase the pain.

In this study of 88 children, antibiotics were avoided and the ear infections went away with pain treatment alone in 89% of the children (ages 2-18) who received the ear drops. Three of the children who did not initially receive antibiotics did have complications from spreading infection (pneumonia, perforated ear drum, bleeding), but all recovered without problems. Among the children who did receive antibiotics initially, 95% had their ear infections go away while they were on the antibiotics. Two of the children in the antibiotic group had complications (rash, diarrhea); they recovered as well.