top of page
Search

Doctor, are these ear drops right for me?

Good morning and TGIF! Welcome to another edition of Dr Euan's ENT blogpost!


The topic for today's blogpost is ear drops.


There are many different types of ear drops that can help you treat different conditions. Some ear drops can be bought over the counter, whereas some medicated eg antibiotic drops may require a prescription.


So if you want to know what kind of ear drops are right for you, let's have a look together shall we?


Q: What types of ear drops are there? What are they made of?

Ear drops are liquid medications that you put inside your ear canal. You can buy some kinds of ear drops over the counter. Others require a prescription from a doctor.


You should consult your doctor before using ear drops, especially if you have any drug allergies.


Additionally, you should avoid using ear drops at all if you think you might have a ruptured eardrum. Symptoms of a ruptured eardrum include ear pain, hearing loss, ringing in your ears (tinnitus), ear drainage and vertigo.


Q: What are some conditions ear drops are used to treat?

You may need to use ear drops if you have certain ear conditions, such as:

Q: What kind of ear drops help to clear ear wax?

If you have ear wax buildup, certain ear drops can soften and loosen your earwax for easier removal.

You may want to consider using eardorps to help hardened earwax come out


There are three types of softening drops for earwax: water-based, non-water-based and oil-based. If you have impacted earwax, your GP may recommend ear drops containing:

  • Carbamide peroxide.

  • Hydrogen peroxide.

  • Glycerin.

  • Sodium bicarbonate.

Once the medication has time to work, you should gently rinse your ear canals with warm water. Some products come with an ear syringe to make this step easier. Be sure to follow the instructions on the product packaging. If in doubt, please consult your GP.


Q: How do I know what kind of ear drops are right for me if I have an ear infection?

If you have an ear infection, your healthcare provider may recommend antifungal or antibiotic ear drops to help clear the infection.


Active ingredients in these antibiotic ear drops often include:

  • Acetic acid.

  • Aluminum acetate.

  • Ciprofloxacin.

  • Ofloxacin.

  • Tobramycin.

  • Gentamicin.


For Fungal infections, you will find these ingredients :

  • Clotrimazole.

  • Fluconazole.

  • Miconazole.

CAN I GET ANTIBIOTIC EAR DROPS OVER THE COUNTER?

No, antibiotic ear drops are NOT available over the counter. These medications require a prescription from a doctor.


Q: What kind of ear drops are suitable for children?

Generally, there is NO difference in treating children, for ear infections, your GP or ENT doctor may want to take an Ear swab for some discharge to send for Culture & Sensitivity to ascertain the most appropriate antibiotic ear drops for your child. So it may be a good idea to consult your GP / Paediatrician.


How should I use ear drops?

Here are some simple tips for helping you put ear drops in your ears:

  • Warm the bottle in your hand. (Ear drops that are too cool or too warm can cause dizziness.)

  • Lie down with the affected ear facing up toward the ceiling.

  • Hold the outer part of your ear (just above your ear lobe) and gently pull back. This helps straighten your ear canal.

  • Place the recommended number of drops into your ear canal.

  • Massage your tragus (the little piece of tissue that sits just in front of your ear canal). This encourages the drops down your ear canal.

  • Lie on your side for a few minutes. This allows the ear drops to reach your eardrum.

  • Sit up and allow any excess drops to drain out of your ear.

  • Do NOT stick objects in your ear canal, such as a cotton swab or hairpins.

Olive oil ear drops can help to loosen earwax and sometimes may even help it to fall out on its own


Q: When should I seek ear drops as treatment?

As outlined above, you can try ear drops as a first-line treatment, however, if the problem does NOT respond within a week, please see your GP or ENT doctor.


Q: How long will I need to use ear drops?

This depends on the condition and the type of ear drops you use. Ask your doctor how many days you’ll need to use ear drops. Closely follow the instructions on the packaging. If the ear condition does not improve by a week, please arrange to review with your doctor / ENT specialist.


Q: What are the benefits of using ear drops?

Ear drops can kill bacteria and fungi faster than oral medication. In some cases, ear drops may be the only treatment you need.


Q: What are the side effects of using ear drops?

The most common side effect is a stinging or burning sensation in your ear canal. This usually goes away within a few minutes and isn’t a cause for concern. However, if your symptoms worsen or do not go away, call your doctor for advice.

Anti-fungal ear drops eg Canestan do tend to have more such stinging effects.


Q: What are the risks of using ear drops?

Serious complications are rare, but you should call your doctor if you develop:

  • New pain symptoms

  • Redness or swelling around your ears.

  • Signs of an allergic reaction, such as rash, dizziness or difficulty breathing.

  • Hearing loss or tinnitus (ringing).


Q: Will ear drops help if I have something stuck in my ear?

OH NO! If you can feel something stuck, or moving inside your ear, eardrops might help, but they may not help if the blockage is too big.


If you feel there is something stuck inside your ear canal, it is best to see your GP or ENT doctor to have a check-up; as sometimes you may be surprised what you find!


Please see my previous blogpost on when there is something stuck in your ear!


Have a great relaxing weekend! TGIF!


Dr Euan


If you would like to consult a specialist about ear drops, or any other ENT-related conditions, please feel free to Contact Us at Euan's ENT Surgery & Clinic to make an appointment.


If you are interested to read up more on EAR DROPS and their uses, do have a deeper dive into these references


REFERENCES:


1. Topical antibiotics for chronic suppurative otitis media. Brennan-Jones CG, Head K, Chong LY, Burton MJ, Schilder AG, Bhutta MF. https://doi.org/10.1002/14651858.CD013051.pub2 Cochrane Database Syst Rev. 2020;1:0. [PMC free article] [PubMed] [Google Scholar]

2. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. https://doi.org/10.1136/bmj.c2096 BMJ. 2010;340:0. [PubMed] [Google Scholar]

3. Critical shortage of new antibiotics in development against multidrug-resistant bacteria—time to react is now. Freire-Moran L, Aronsson B, Manz C, Gyssens IC, So AD, Monnet DL, Cars O. https://doi.org/10.1016/j.drup.2011.02.003. Drug Resist Updat. 2011;14:118–124. [PubMed] [Google Scholar]

4. Antibiotic resistance—the need for global solutions. Laxminarayan R, Duse A, Wattal C, et al. Lancet Infect Dis. 2013;13:1057–1098. [PubMed] [Google Scholar]

5. Intratympanic gentamicin for Meniere’s disease; a survey of current UK practice. Obholzer RJ, Wareing MJ. https://doi.org/10.1258/002221503321892299. Journal of Laryngology and Otology. 2003;117:459–461. [PubMed] [Google Scholar]

6. Comparative evaluation of the antibacterial and physical properties of conventional glass ionomer cement containing chlorhexidine and antibiotics. Mittal S, Soni H, Sharma DK, Mittal K, Pathania V, Sharma S. J Int Soc Prev Community Dent. 2015;5:268–275. [PMC free article] [PubMed] [Google Scholar]

7. Evidence review and ENT-UK consensus report for the use of aminoglycoside-containing ear drops in the presence of an open middle ear. Phillips JS, Yung MW, Burton MJ, Swan IR. https://doi.org/10.1111/j.1749-4486.2007.01532.x. Clin Otolaryngol. 2007;32:330–336. [PubMed] [Google Scholar]

8. Topical aural antibiotic use in the UK - time for a change of policy? Youngs R, Fisher E, Hussain M, Fishman J. https://doi.org/10.1017/S002221511500331X. J Laryngol Otol. 2016;130:1. [PubMed] [Google Scholar]

9. Ototoxicity of ototopical drops—an update. Haynes DS, Rutka J, Hawke M, Roland PS. Otolaryngol Clin North Am. 2007;40:669-83, xi. [PubMed] [Google Scholar]

10. Eardrops and aminoglycoside ototoxicity revisited. Tange RA. https://pubmed.ncbi.nlm.nih.gov/11668866/ Adverse Drug React Toxicol Rev. 2001;20:164–168. [PubMed] [Google Scholar]

11. Ototoxicity from ototopical aminoglycosides. Hui Y, Park A, Crysdale WS, Forte V. https://pubmed.ncbi.nlm.nih.gov/9055175/ J Otolaryngol. 1997;26:53–56. [PubMed] [Google Scholar]

12. Ototoxicity of ear drops: a clinical perspective. Linder TE, Zwicky S, Brändle P. https://pubmed.ncbi.nlm.nih.gov/8588672/ Am J Otol. 1995;16:653–657. [PubMed] [Google Scholar]

13. Ototoxicity of ear drops in patients suffering from chronic otitis media. Podoshin L, Fradis M, Ben David J. https://doi.org/10.1017/s0022215100108011. J Laryngol Otol. 1989;103:46–50. [PubMed] [Google Scholar]

14. Topical ciprofloxacin for otorrhea after tympanostomy tube placement. Force RW, Hart MC, Plummer SA, Powell DA, Nahata MC. https://doi.org/10.1001/archotol.1995.01890080048009. Arch Otolaryngol Head Neck Surg. 1995;121:880–884. [PubMed] [Google Scholar]

15. Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study. Esposito S, D'Errico G, Montanaro C. https://doi.org/10.1001/archotol.1990.01870050057006. Arch Otolaryngol Head Neck Surg. 1990;116:557–559. [PubMed] [Google Scholar]

16. Effects of topical otic preparations on hearing in chronic otitis media. Ozagar A, Koc A, Ciprut A, Tutkun A, Akdaş F, Sehitoğlu MA. https://pubmed.ncbi.nlm.nih.gov/9339804/ Otolaryngol Head Neck Surg. 1997;117:405–408. [PubMed] [Google Scholar]

17. Do aminoglycoside otic preparations cause ototoxicity in the presence of tympanic membrane perforations? Wong DL, Rutka JA. https://doi.org/10.1016/s0194-59989770284-5. Otolaryngol Head Neck Surg. 1997;116:404–410. [PubMed] [Google Scholar]

18. Ototoxicity and topical eardrops. Marais J, Rutka JA. https://doi.org/10.1046/j.1365-2273.1998.00161.x. Clin Otolaryngol Allied Sci. 1998;23:360–367. [PubMed] [Google Scholar]

19. Ototoxicity of topical gentamicin preparations. Bath AP, Walsh RM, Bance ML, Rutka JA. Laryngoscope. 1999;109:1088–1093. [PubMed] [Google Scholar]

20. Gentamicin ear drops and ototoxicity: update. Canadian ADR Newsletter. https://www.proquest.com/openview/aaa793bead511d25b8f87a923154814a/1?pq-origsite=gscholar&cbl=41339 Jan. 2001;5 [PubMed] [Google Scholar]

21. Update on topical ototoxicity in chronic suppurative otitis media. Rutka J. https://pubmed.ncbi.nlm.nih.gov/12199183/ Ear Nose Throat J. 2002;81:18–19. [PubMed] [Google Scholar]

22. Topical ciprofloxacin versus topical gentamicin for chronic otitis media. Nawasreh O, Fraihat A. https://pubmed.ncbi.nlm.nih.gov/12596948/ East Mediterr Health J. 2001;7:26–30. [PubMed] [Google Scholar]

23. Efficacy of topical ciprofloxacin and tobramycin in combination with dexamethasone in the treatment of chronic suppurative otitis media [Article in Turkish] Kaygusuz I, Karlidağ T, Gök U, Yalçin S, Keleş E, Demirbağ E, Kaygusuz TO. https://pubmed.ncbi.nlm.nih.gov/12122630/ Kulak Burun Bogaz Ihtis Derg. 2002;9:106–111. [PubMed] [Google Scholar]

24. Use of topical ciprofloxacin in chronic suppurating otitis media. Ramos A, Ayudarte F, de Miguel I, et al. Acta Otorrinolaringologica Espanola. 2003;54:485–490. [PubMed] [Google Scholar]

25. The curative effect of rifampicin solution in the treatment of chronic suppurative otitis media. Liu J. Journal of Preclinical Medicine College of Shangdong University. 2003;17:8–9. [Google Scholar]

26. Comparison of efficacy of topical ofloxacin and gentamycin in tubotympanic type of chronic suppurative otitis media. Asmatullah Asmatullah, Khan Q, Nawaz G, et al. https://www.researchgate.net/publication/286617170_Comparison_of_efficacy_of_topical_ofloxacin_and_gentamycin_in_tubotympanic_type_of_chronic_suppurative_otitis_media Medical Forum Monthly. 2014;25:68–71. [Google Scholar]

28. Experimental studies on round window structure: function and permeability. Goycoolea MV, Muchow D, Schachern P. Laryngoscope. 1988;98:1–20. [PubMed] [Google Scholar]

29. Ototoxicity: a challenge in diagnosis and treatment. Ganesan P, Schmiedge J, Manchaiah V, Swapna S, Dhandayutham S, Kothandaraman PP. J Audiol Otol. 2018;22:59–68. [PMC free article] [PubMed] [Google Scholar]

30. Ototoxicity of ototopical antibiotic drops in humans. Matz G, Rybak L, Roland PS, et al. Otolaryngol Head Neck Surg. 2004;130:0–82. [PubMed] [Google Scholar]

31. Why are ototopical aminoglycosides still first-line therapy for chronic suppurative otitis media? A systematic review and discussion of aminoglycosides versus quinolones. Harris AS, Elhassan HA, Flook EP. J Laryngol Otol. 2016;130:2–7. [PubMed] [Google Scholar]

32. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. [ Dec; 2022 ]. https://www.nice.org.uk/bnf-uk-only

33. Clinical practice guideline: acute otitis externa. Rosenfeld RM, Schwartz SR, Cannon CR, et al. Otolaryngol Head Neck Surg. 2014;150:0. [PubMed] [Google Scholar]


34. Mandel E.M. Casselbrant M.L. Kurs-Lasky M.

Acute otorrhea: bacteriology of a common complication of tympanostomy tubes. Ann Otol Rhinol Laryngol. 1994; 103: 713-718


35. Isaacson G.

Why don’t those eardrops work for my patient?. Pediatrics. 2006; 118: 1252-1253






Dr Euan Drawing.jpeg

CALL US

ANSWERING SERVICE

EMAIL US

bottom of page