RFSymptoms: Safety netting advice
ChildrenMiddle ear infection
DATE LAST REVIEWED: 05/11/2026
When to seek further review
- Ear infection symptoms usually start improving within 3 days, although they can last a week. Contact the GP if there is no improvement after 3 days.
- Get urgent advice sooner for worsening pain, high fever, fluid leaking from the ear, hearing changes, dizziness or feeling generally unwell.
- Get urgent assessment for swelling or redness behind the ear, particularly if the ear starts to stick out.
- If given a back-up prescription, follow the specific starting instructions from the clinician rather than starting it automatically.
- Do not wait for the suggested review time if symptoms become worse, new symptoms appear, or you are worried.
- Contact your GP when the surgery is open. If it is closed, you cannot get the help you need, or you are unsure what to do, call NHS 111. You can call even if you are not sure whether the symptoms are serious.
When to get emergency help
(Immediately dial 999 or go to your nearest Emergency Department)
- Swelling behind the ear with severe illness or rapid deterioration.
- New facial weakness or drooping.
- A severe headache with a stiff neck, discomfort in bright light, or a rash that does not fade when pressed with a clear glass. Do not wait for a rash to appear.
- A seizure or becoming very difficult to wake.
- Severe difficulty breathing, pauses in breathing, grunting, or the skin pulling in deeply under or between the ribs.
- Being very difficult to wake or unresponsive.
- Being unusually floppy, confused or not responding as usual.
- Blue, grey, very pale or blotchy skin, lips or tongue.
How to spot sepsis
Sepsis is a life-threatening reaction to an infection. It can get worse quickly. If someone is seriously unwell and may have sepsis, call 999 or go to your nearest Emergency Department. Do not wait for every sign, a high temperature or a rash.
An unwell child under 5 who has not had a pee or wet nappy for 12 hours needs emergency assessment. If you are unsure and there are no emergency signs, call NHS 111 for advice.
