Otitis Externa Medication
- Author: Joseph P Garry, MD, FACSM, FAAFP; Chief Editor: Craig C Young, MD more...
Medication Summary
Most cases of otitis externa can be treated with over-the-counter analgesia and antibiotic eardrops. In severe cases, oral or intravenous (IV) antibiotic therapy and narcotic analgesics may be required. In the case of necrotizing otitis externa, the patient must be admitted to a hospital for IV antibiotics at the discretion of the consulting otorhinolaryngologist. The treatment that is rendered is dependent on the likely organism, which is best evaluated with a Gram stain of the affected area.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort and may have sedating properties.
Acetaminophen (Tylenol, Feverall, Aspirin-Free Anacin)
Over-the-counter acetaminophen is appropriate for most patients. DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.
Acetaminophen and codeine (Tylenol #3)
Indicated for the treatment of mild to moderate pain
Antibiotic/corticosteroid, Otic
Class Summary
Most cases of otitis externa are caused by superficial bacterial infections. The small amount of steroid that is present in the solution can help to ease the pain and edema associated with this condition.
Gentamicin/betamethasone (Garamycin, Gentacidin, Celestone phosphate)
Compounded medication. Each mL contains 3 mg of gentamicin sulfate and 1 mg of betamethasone sodium phosphate
Ciprofloxacin 0.3% /Dexamethasone 0.1% (Ciprodex)
This otic suspension is indicated for use in otitis externa, as well as otitis media in individuals with tympanostomy tubes.
Antifungal Agent, Topical
Class Summary
A small but significant percentage of otitis externa cases are due to the Aspergillus species. The mechanism of action usually involves inhibiting the pathways (eg, enzymes, substrates, transport) that are necessary for sterol/cell membrane synthesis or for altering the permeability of the fungal cell membrane (eg, polyenes).
Clotrimazole 1% otic solution (Lotrimin AF)
Compounded medication. Broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability, causing death of fungal cells.
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