Current American Academy of Pediatrics (AAP) recommendations state that uncomplicated ear infections should be observed for 48 hours before starting antibiotics.
If your child improves during this time, an antibiotic is not necessary. During this “waiting period,” it is very unlikely that the eardrum will rupture, since up to 80 percent of infections will resolve on their own. However, if you see yellowish or whitish discharge coming from your child’s ear, you should seek medical attention right away. Your child will likely be started on either an oral antibiotic, an antibiotic ear drop, or both. The good news is that eardrum ruptures usually heal on their own with no further intervention.