Ear Infection (Otitis) in Japan: Treatment for Adults & Children

Overview: Ear Infections for Travelers in Japan

Ear infections (中耳炎 *chūji-en* / 外耳炎 *gaiji-en*) are among the most common conditions treated by ENT specialists (耳鼻咽喉科, *jibi inkōka*) in Japan. Two main types affect travelers:

Otitis Media (中耳炎, *chūji-en*) — Middle ear infection:

• Most common in children under 5, but adults can be affected
• Often follows a cold or upper respiratory infection
• Fluid and infection behind the eardrum
• Extremely painful; may cause temporary hearing loss

Otitis Externa (外耳炎, *gaiji-en*) — Outer ear infection ("Swimmer's Ear"):

• Infection of the ear canal (outer ear)
• Common after swimming in pools or natural waters
• Also triggered by inserting cotton swabs too deeply or using earphones extensively
• Japan's public pools and summer beach culture make this particularly relevant for tourists

Why travelers are at risk:

• Swimming in hotel pools, onsen (hot springs), Japanese beaches, or water parks
• Children's susceptibility during family travel
• Pressure changes from flying affecting eustachian tube function
• Altitude changes when visiting mountainous areas
• Colds and respiratory infections acquired during travel

Japan's ENT care is of very high quality, with sophisticated otoscopic examination equipment and experienced ENT specialists available in most cities and towns.

Symptoms and Diagnosis

Otitis Media (Middle Ear Infection):

Otitis Externa (Swimmer's Ear):

• Ear canal pain, especially when pulling the outer ear or pushing the tragus (the small flap in front of the ear canal)
• Itching in the ear canal
• Discharge or drainage (may be watery, cloudy, or puslike)
• Feeling of fullness in the ear
• Hearing may be muffled if canal is swollen shut
• Pain worsens when chewing

Diagnosis at a Japanese ENT Clinic:

ENT doctors in Japan use an otoscope (耳鏡, *jikyō*) or video otoscope to directly visualize the ear canal and eardrum. The examination is quick and not painful. They assess:

• The appearance of the eardrum (red, bulging, or perforated for otitis media)
• The condition of the ear canal (inflamed, narrowed, with discharge for otitis externa)
• Hearing assessment if indicated (audiometry / 聴力検査)
• Tympanometry (鼓膜の動き検査) to assess middle ear pressure

Treatment in Japan

Otitis Media (Middle Ear Infection):

Common antibiotics prescribed in Japan for otitis media:

• Amoxicillin (アモキシシリン): standard first-line
• Amoxicillin/clavulanate (オーグメンチン): for treatment-resistant cases
• Cefdinir (セフジニル): cephalosporin alternative

Pain management: acetaminophen (アセトアミノフェン) or ibuprofen — both effective for ear pain. Japanese pharmacies sell these OTC.

Otitis Externa (Swimmer's Ear):

• Antibiotic ear drops (耳用点耳薬): ofloxacin (タリビッド点耳薬) or ciprofloxacin ear drops
• Combination drops with steroid to reduce inflammation (e.g., リンデロン-VG)
• ENT doctor may gently clean the ear canal at the clinic (耳の掃除)
• Keep the ear dry: avoid swimming until fully healed; use a cotton ball with petroleum jelly in the ear opening when showering
• Do not use cotton swabs during treatment

In-Clinic Ear Cleaning (耳の処置):

Japanese ENT clinics commonly perform ear cleaning and suction as part of treatment. The ENT doctor or trained nurse uses a microscope and small instruments to remove accumulated debris, dried discharge, or wax that may be contributing to the infection or preventing ear drops from reaching the site of infection. This procedure is: