TacAir wrote:For OTC (no Rx required)
Ocutricin brand ophthalmic solution (bacitracin, neomycin, and polymyxin B ophthalmic) good for eyes and ears + is triple antibiotic, so good for boo-boos that might get infected. Buffered for use as an ophthalmic solution so the cost is higher, offset by multiple uses possible.
You should never use neomycin in the ears. It can leave you deaf.
There is no doubt that some ingredients of older ear drops, especially but not limited to aminoglycosides, have the potential to cause severe cochlear and vestibular ototoxicity. Neomycin is probably the most toxic of the aminoglycosides followed by gentamicin and tobramycin.
" onclick="window.open(this.href);return false;
First, thank you for the link. I respectfully disagree with the 'never'.
A quick review for lurkers on the board shows:
What is and how can we treat acute external otitis
External otitis or "swimmer's ear" is an infection of the skin covering the outer ear and ear canal. Acute external otitis is commonly a bacterial infection caused by streptococcus, staphylococcus, or pseudomonas types of bacteria. The swimmer's ear infection is usually caused by excessive water exposure from swimming, diving, surfing, kayaking, or other water sports.
When water collects in the ear canal (frequently trapped by wax), the skin can become soggy and serve as an inviting area for bacteria to grow. Cuts or abrasions in the lining of the ear canal (for example, from cotton swab injury) can also predispose to bacterial infection of the ear canal. Swimming in polluted water nearly guarantees this condition.
Treatment with buffered medication which contains neomycin and polymyxin, which are antibiotics that work by stopping the growth of bacteria, is usually an effective treatment.
I would NOT use the antibiotic in the case of a perforated eardrum - my apologies to readers of the board for not being specific in that count.
The best course of treatment for a perforated eardrum, esp. with children, would be symptomatic treatment of pain and to seek professional care from ENT specialist. I carry an otoscope and am versed in the use of the device.
The linked article states:
Ototoxicity is a rare
but potentially serious complication of the use of aminoglycoside and other cochleo-toxic ear drops.
Fortunately, I am intimately familiar with the people I treat, and have solid knowledge of their medical history and that of their parents, drug sensitivity being a key feature of my notes. I am mostly present even when they receive professional care. I would hope that anyone who reads ZS will make the effort to obtain a solid pt history before any treatment for a non-life threatening condition.
This ototoxicity risk is increased when there is a perforation of the tympanic membrane or a patent grommet. You are correct bring this this up as a complicating faction in any
treatment. The modality of the tympanum perforation is key in understanding what treatment would be appropriate. The type of injury - opening, erosion, or rupture to the tympanic membrane (eardrum) may be the result of infection, trauma, or the negative pressure associated with underwater diving or flying.
Further, the article notes that until recently, no alternatives to potentially ototoxic antibiotic ear drops were approved in Australia
. The new medicine noted requires a script, usually after a visit to a health care professional.
I'll keep my Ocutricin brand ophthalmic solution im my extended FAK for use as appropriate.
Thank you for bringing up issues related to treatment with perforation and the care that should be exercised. As the OP was looking for "Over the Counter" meds, I thought some readers might see the value of an item with multiple uses.
As for the prescription items others have listed earlier in this thread - I, too, enjoin folks from self-medication or handing out drugs based on advice from Dr. Google.
I'm not a doctor nor am I offering medical advice, only journaling what I use for the care of the folks who look to me for treatment. As they say, YMMV.