Hi Mike. If you have taken 4 courses of antibiotics without resolution, you probably do not have an infection. Are you having any pain in your jaw or your teeth on the right side?
The ear is a crossroads, of sorts, for several nerves. Pain in the ear that is identical to that of an infection may actually be radiating into the ear from the jaw (e.g. TMJ) or the back molars (e.g. impacted or abscessed tooth). Have you consulted with a dentist?
Does it hurt more when you chew on the right side in the back? Are the teeth sensitive to hot liquids or cold liquids?
So it is almost constant? Any associated dizziness (vertigo) or hearing loss?
Your pain may indicate a problem with the temporomandibular joint immediately in front of the ear, or the parotid gland that envelops the lower part of the ear. Other possibilities would be a shingles infection in the ear canal, which is very painful but your doctor should have seen, or Meniere's disease which usually has more dizziness and ringing than pain, but could be atypical in your case. An ENT physician can sort this out for you. See if you can get a referral. In the meantime, ask your doctor for a nerve-stablizing medication such as gabapentin or pregabalin. This should help to soften the sharp pains. In addition, an anti-inflammatory such at motrin or naprosyn might be quite helpful for controlling the pain.
You're welcome. Hope all works out for the best and you get some relief soon.