From the Research
The initial treatment for acute labyrinthitis should focus on symptom management and supportive care, with vestibular suppressants being the mainstay of treatment, as evidenced by the most recent study 1. The goal of treatment is to reduce vertigo, nausea, and vomiting, and to promote central compensation mechanisms.
- Vestibular suppressants such as diazepam (5-10mg orally every 6-8 hours as needed), meclizine (25-50mg orally every 4-6 hours as needed), or promethazine (25mg orally, rectally, or intramuscularly every 4-6 hours) are commonly used medications, as supported by earlier studies 2, 3.
- Antiemetics such as ondansetron (4-8mg orally every 8 hours) may be added if nausea persists.
- Bed rest is recommended during the acute phase, with gradual resumption of normal activities as symptoms improve, typically within 1-3 days.
- Adequate hydration should be maintained, especially if vomiting occurs.
- Vestibular suppressants should be used for the shortest duration possible (usually 3-5 days) to avoid delaying central compensation mechanisms, as suggested by 3.
- If a bacterial infection is suspected, antibiotics may be prescribed.
- Vestibular rehabilitation exercises are beneficial once the acute phase has passed to promote central compensation and reduce the risk of persistent symptoms, as indicated by 1, which highlights the poor prognosis for both hearing and balance function impairment in patients with idiopathic labyrinthitis.