Should I be concerned about my ear infection and perforated eardrum?

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It appears with your history that you are suffering from an upper respiratory tract infection that has complicated into an ear infection. Usually, once the antibiotic course starts, the problem should resolve within three to four days and completely by five to seven days. It is normal to have mild, dull ache behind the ear during the acute course. If you have diabetes, then the healing may get delayed. It is advisable to check your sugar levels and visit your doctor if they are high. Pain and tenderness behind the ear may worsen, resulting in a swelling or bulge behind the ear. It may be accompanied by pushing out of the said ear. This is a case of acute mastoiditis, which means the antibiotic is not working and pus is continuously forming. In such a case you must visit the doctor soon as it may require a surgical drainage. If the fluid coming out of the ear is still yellow or greenish, then you may need to send the fluid for a microbiological examination for culture sensitivity test. You may have to change the antibiotic as per the report. However, if the fluid is watery or mucoid, but profuse, then you need not worry. We can add a mucolytic drug to accentuate its drainage. Ambroxol hydrochloride, N-acetylcysteine and Bromhexine are some of the mucolytic available. Check with your doctor if he has given you any of these along with the antibiotic. An antihistamine like Fexofenadine (120 mg) or Loratadine (10 mg) taken once daily can also help keep the ear dry. Usually, the perforated drum closes on its own if you follow some precautions like keeping the ear dry and preventing throat infections. Small perforations heal on their own. If the ear perforation does not heal on its own and lasts more than three months, then we can do an otoscopic examination and plan for an endoscopic tympanoplasty that grafts the perforation with a new ear drum (taking tragal perichondrium as a graft). The techniques for tympanoplasty vary and this is what we do in my setup. Till the same I suggest you continue the medicines.