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Drops, not pills, best for swimmer's
ear
Thu Jan 21, 2010 3:10pm EST
NEW YORK (Reuters Health) - Antibiotic
or antiseptic drops are the best approach to treating swimmer's
ear, according to a new research review. And while oral antibiotics
are often prescribed along with ear drops to treat swimmer's ear,
this is not necessary, the reviewers say.
Swimmer's ear -- known medically as
acute otitis externa -- is an inflammation of the ear canal that
may or may not involve infection. A person's ear may feel blocked
and touching or gently pulling the ear may be painful.
Eardrops have been the mainstay of
treatment for swimmer's ear for over 50 years, but studies have
shown as many as 40 percent of these patients may also receive a
prescription for oral antibiotics.
To investigate the best approach to
treating the condition, Dr. Vivek Kaushik of the Stepping Hill
Hospital in Stockport, UK, and colleagues looked at 19 randomized
clinical trials including 3,382 patients in all. Treatments
evaluated included astringent (drying), antiseptic, antibiotic, and
steroid ear drops; various combinations of these topical
treatments; oral antibiotics; and ear cleaning.
Overall, the researchers found,
antibiotic or antiseptic drops, with or without steroids, produced
a 55 percent to 100 percent cure rate for swimmer's ear, compared
to a 10 percent cure rate for inactive placebo drops.
Given that all of the topical
treatments tested seemed to be equally effective, Kaushik and
colleagues say, doctors may decide which therapy to use based on
cost, risk of toxicity to the ear, and other concerns.
Typically, symptoms will last for about
six days after a person starts treatment, the researchers say, and
doctors usually recommend a patient use the treatment for seven to
10 days. "It may be more useful when prescribing ear drops to
instruct patients to use them for at least a week," they add. If
symptoms persist, according to the researchers, the patient should
keep using the drops for up to seven more days; if symptoms last
for more than two weeks, another treatment should be
tried.
A prescription for oral antibiotics may
be warranted in certain cases, Kaushik notes, for example when the
infection has spread to the inner ear or face.
The findings appear in the most recent
issue of The Cochrane Library, a publication of the Cochrane
Collaboration, an international non-profit group that evaluates
medical research and makes evidence-based recommendations on
treatment.
People who are prone to developing
swimmer's ear can protect their ears when they swim by using ear
plugs or a bathing cap, or even placing petroleum jelly-smeared
cotton balls over the ear canal, Dr. Richard Rosenfeld, chairman of
otolaryngology at SUNY-Downstate Medical Center in Brooklyn, New
York, told the Health Behavior News Service.
Those who get frequent infections can
help prevent them by using antibiotic or antiseptic drops after
swimming, noted Rosenfeld, who was not involved in Kaushik's study.
A home-made mix of half white vinegar, half rubbing alcohol can
work just as well as store-bought ear drops, according to
Rosenfeld.
SOURCE: The Cochrane Library
2010.
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