Azithromycin for Ear Infection – Dosage, Side Effects, and More

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Ear infections can go away on their own, so managing the pain and maintaining a close eye on the condition can be the first steps of treatment. However, it’s essential to treat them straight away to prevent complications, especially if a child is impacted and is inadequate to care for their ears safely so they can heal on their own. Azithromycin for ear Infection is one proven and tested effective treatment.

A middle ear infection, also called otitis media, is an infection of the air-filled area behind the eardrum where the small vibrating bones of the ear are located. Otitis media is an infectious disease that affects children due to their immature immune systems, which are less able to fend off infections, and their smaller, more horizontal eustachian tubes, which make it hard for fluid to drain from the ear. However, this condition also affects adults.

To help you better understand how Azithromycin can treat ear infections, this article will provide you with everything you need to know about Azithromycin and more information about the disease.

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What Are Symptoms of an Ear Infection?

Most ear infections heal on their own in up to 3 days. However, the symptoms of otitis media need to be monitored because they could worsen and cause complications, mainly if children are the ones experiencing the condition. You will need to see a doctor and have the necessary treatment by then.

Here are some typical symptoms of an ear infection to look out for.

Ear infection symptoms in children:

  • Crying more than usual
  • Complains of pain in the ear, mainly when lying down
  • Grabbing or pulling an ear
  • Blisters on the outer ear or the ear canal
  • Difficulty sleeping
  • Loss of appetite
  • Fussiness
  • Difficulty hearing or recognizing sounds
  • Loss of balance
  • Fever of 100 f (38 c)
  • Fluid coming out of the ear
  • Complain about headache

Ear infection symptoms in adults:

  • Pain in the ear
  • Fluid coming out of the ear
  • Difficulty hearing
  • Itching of the outer ear
  • Blisters on the outer ear or the ear canal
  • Vertigo: loss of balance

How Are Ear Infections Treated?

A minor ear infection, also known as acute otitis media, can be treated at home. Avoid lying on the side of the affected ear, and try applying a warm compress to it. You can take over-the-counter (OTC) pain relievers if the pain is persistent. If children have an ear infection, it sometimes happens that after waiting a few days, they start to feel better without medication.

If the condition becomes too severe to treat at home, you can visit the doctor, who will have the appropriate medications to treat the condition effectively. Azithromycin for ear infections can be one of them. They are typically treated with an oral drug lasting 7 to 10 days.

Azithromycin Dosage for Ear Infection

Your doctor decides the proper dosage of Azithromycin for you based on your acute otitis media severity. Here are the available dosages that your doctor may prescribe to treat otitis.

Injection, lyophilized powder for reconstitution:

  • 500mg/vial


  • 250mg
  • 500mg

Oral suspension:

  • 100mg/5mL
  • 200mg/5mL

Depending on the condition of your otitis, these available dosages will also provide you with options on how to take the medication to treat it. Azithromycin is typically taken once per day. You should swallow tablets and pills whole along with some water. You can drink tablets and liquids with or without food. Liquid Azithromycin is an option for kids and those with trouble swallowing tablets. However, the liquid Azithromycin may have a bitter or unpleasant aftertaste.

Common side effects of using Azithromycin for ear infection

Side Effects

Azithromycin is a solid and effective antibiotic in treating bacterial infections. While Azithromycin is effective in treating ear infections, it does have possible side effects. However, not all people will experience them.

Common side effects of Azithromycin:

  • Nausea
  • Abdominal pain
  • Diarrhea
  • Vomiting
  • Loss of appetite
  • Headaches
  • Dizziness

Rare but possible side effects of Azithromycin:

  • Cloudy urine
  • Body aches and joint pain
  • Burning while urinating
  • Chest pain
  • Difficulty breathing
  • Nausea
  • Dryness or soreness of the throat
  • Racing heartbeat or pulse
  • Headache
  • Loss of appetite
  • Jaundice

Most side effects vanish within a few days of taking the drug, while some will only disappear when the appropriate dosage has been reached. Therefore, it is essential to visit the doctor who prescribed the Azithromycin if side effects persist even after completing the required duration of the medication.

Why Is This Medication Prescribed?

Azithromycin is a U.S. Food and Drug Administration-approved macrolide-type antibiotic used to treat many bacterial infections. It works by preventing the development of infection-causing bacteria. Azithromycin is always prescribed because it has been found in numerous studies to be highly effective in stopping bacterial growth and reproduction. Thereby effectively treating midear infections that occur when bacteria infect and trap fluid behind the eardrum, resulting in pain and swelling of the ears.

How Long Does Azithromycin Take To Work for Ear Infection?

Azithromycin is usually prescribed as a 10-day course treatment depending on the type of ear infection being treated. However, you’ll notice its effects and significantly improve within the first three days.

If the infection results in a fever, it should subside by day two or 48 hours after the medication is started.

By day two, the ear pain and discomfort should subside.

By day three, other acute otitis media symptoms should be gone.

However, even if the symptoms are gone and you feel better, you must adhere to and complete the course that your doctor recommended, ensuring that the infection is completely gone and has no risk of returning.

How Effective Is Azithromycin for Ear Infection

According to a study published by Medscape Wire, children with middle ear infections who get a single dosage of Azithromycin responded to treatment in a manner that was clinically comparable to that of children who received a 10-day course of amoxicillin (86 percent vs. 88 percent, respectively; P=. 60).

As a result, Azithromycin is a proven fast and effective treatment for ear infections.

Azithromycin can interact with other medications if a person does have maintenance drugs. For instance, an HIV patient using Azithromycin and the HIV medication nelfinavir will risk hearing issues and liver abnormalities.

Tell your doctor about any maintenance medications you take to ensure that the appropriate treatment for your acute otitis media is administered and is safe for your ongoing medications.

Here are other medicines that can interact with Azithromycin:

  • Digoxin (cardiac medication)
  • Colchicine (gout medication)
  • Phenytoin (seizure medication)
  • Antacids (neutralizes stomach acidity)

Alternatives to Azithromycin for Ear Infection

Azithromycin is one of the most well-known and effective medications for treating an ear infection. However, there are alternatives to Azithromycin for treating ear infections if you are not permitted to use it due to potential side effects, drug interactions, or maintenance requirements.

Several effective antibiotics can be used as an alternative to Azithromycin to treat bacterial infections, including ear infections. Here are a few effective alternatives for treating ear infections that your doctor may also recommend:

  • Amoxil (amoxicillin)
  • Augmentin (amoxicillin/potassium clavulanate)
  • Cortisporin (neomycin/polymyxin b/hydrocortisone)
  • Cortisporin TC (colistin/neomycin/thonzonium/hydrocortisone)
  • Ciprodex (ciprofloxacin/dexamethasone)
  • Cipro HC (ciprofloxacin/hydrocortisone)
  • Ciloxan (ciprofloxacin)
  • Ocuflox (ofloxacin)
  • Floxin (ofloxacin)
  • Acetal HC (hydrocortisone/acetic acid)

When To See a Doctor

An ear infection frequently gets better on its own in a few days. In particular, if you have acute otitis media, you’ll notice that the symptoms start to go away as soon as three days pass. However, it would help if you didn’t let your guard down.

You should see a doctor if you experience the following:

  • Symptoms persist after three days.
  • High fever with a body temperature increase of more than 100.4 degrees. This can be a sign of a more severe infection.
  • A substantial amount of fluid, pus or bloody fluid comes out of the ear.
  • The discomfort and pain from the ear are unbearable.
  • If you have a child under the age of six months and exhibit the common signs of acute otitis media.

Frequently Asked Questions

Zithromax, also known as Z-pak, is a known Azithromycin brand, an effective macrolide antibiotic treatment for ear infections. 

Augmentin is a penicillin-type antibiotic and a beta-lactamase inhibitor that effectively treats ear infections. However, Zithromax requires fewer dosages than Augmentin. So, it is safe to presume that a single tablet of Zithromax is more potent. But, the bottom line, Augmentin can perform the same and is very effective in treating ear infections with the proper prescribed doses.

For adults, the doctor may prescribe a specific dosage of Azithromycin depending on the severity of your acute otitis media. Here is the standard Azithromycin adult dosage for treating ear infections:

  • Tablet: 250mg or 500mg per day
  • Oral Suspension: 100mg/5mL or 200mg/5mL per day

Liver problems that include symptoms such as:

  • Weakness
  • Loss of appetite
  • Severe abdomen pain
  • Dark urine
  • Jaundice (Skin and eyes turns yellowish)

QT prolongation; can result in a rapid or erratic heartbeat. Symptoms include:

  • A rushing sensation in your chest
  • Gasping while sleeping
  • Fainting

Severe allergic reactions. Symptoms include:

  • Hives
  • Swelling of face, lips, tongue, or throat
  • Severe skin reactions (rash, blisters, itching, and burning)

The macrolide antibiotic azithromycin has a broad spectrum, a long half-life, and high tissue penetration. It successfully maintains tissue concentrations in many different parts of the body, including the middle ear. These pharmacokinetic features enable once-daily dosing and more condensed treatment plans. Therefore, one of the finest treatments for ear infections is Azithromycin. 

It is possible that Azithromycin can work against a middle ear cartilage infection, depending on what infection is causing it. However, Azithromycin is a prescription medication. Therefore, you need to see your doctor if your cartilage infection is severe, and your doctor will prescribe the correct antibiotic or remedy. 

Yes. Azithromycin is one of the most effective remedies for ear infections that has been demonstrated and tested. Azithromycin is a macrolide-type antibiotic used to treat many bacterial infections, including ear infections. If your doctor prescribes Azithromycin because you or your child has otitis, follow the prescribed doses and give the medication to your child exactly as instructed. 

Azithromycin is frequently given for ten days of treatment, depending on the severity of the infection. However, you will notice its effects as early as 2 to 3 days. Your ear infection symptoms will be gone in as little as three days. Likewise, if you have a fever because of an ear infection, you’ll notice the fever will get better in two days.

Your doctor will prescribe you the exact days you will need to take Azithromycin. However, following the recommended duration is essential even though the symptoms are gone to ensure the bacteria are eliminated.

The content on Doctor Alexa’s blog is reviewed by Advanced practice registered nurses or pharmacist and is intended for educational purposes only. This information should not be relied upon as professional medical counsel. Be sure to always consult with your physician about the dangers and benefits of any medication, treatment or procedure.

You shouldn’t wait to see the doctor for simple health needs.