From the Guidelines
For treating swimmer's ear, over-the-counter (OTC) ear drops that are effective include those containing antibiotics, antiseptics, steroids, or a combination, as they are highly effective with no consistent advantage shown for any one specific drug 1. When choosing an OTC ear drop for swimmer's ear, it's essential to consider factors such as cost, dosing frequency, and the status of the eardrum.
- All OTC ear drops approved for treating acute otitis externa (AOE) are highly effective, with no consistent advantage shown for any one specific drug 1.
- It's crucial to use the ear drops for at least 7 days, even if symptoms improve sooner, to prevent relapse of infection 1.
- Pain medicine can be used for relief in the first few days, until the ear drops begin working, but pain-relieving (anesthetic) ear drops are not recommended as they can mask symptoms of a delayed response to therapy 1.
- To promote recovery, avoid scratching or touching the ear, and do not insert anything into the ear canal, including cotton-tipped swabs, and cover the opening of the ear canal with an earplug or cotton (with petroleum jelly) prior to showering or hair washing to minimize water entry 1.
- If symptoms persist beyond 7 days, notify your doctor and continue the drops until the symptoms resolve for a maximum of 7 additional days 1.
- It's also important to note that eardrops are, in general, very safe and well tolerated, but some people may report local rash, itching, irritation, or discomfort, and if you taste the ear drops, it may indicate a hole or perforation of the eardrum, so inform your doctor 1.
From the FDA Drug Label
For adults, 4 drops of the suspension should be instilled into the affected ear 3 or 4 times daily. For children, 3 drops are suggested because of the smaller capacity of the ear canal The patient should lie with the affected ear upward and then the drops should be instilled. This position should be maintained for 5 minutes to facilitate penetration of the drops into the ear canal. If preferred, a cotton wick may be inserted into the canal and then the cotton may be saturated with the suspension This wick should be kept moist by adding further suspension every 4 hours. The wick should be replaced at least once every 24 hours.
Polymyxin B (OTIC) and neomycin (OTIC) are two over-the-counter (OTC) ear drop options that can be effective for treating swimmer's ear, with the following key points:
- Dosage: 4 drops for adults, 3 drops for children, 3 or 4 times daily
- Administration: Lie with the affected ear upward, maintain position for 5 minutes
- Optional: Use a cotton wick, keep moist by adding suspension every 4 hours, replace wick at least once every 24 hours 2 3
From the Research
OTC Ear Drops for Swimmer's Ear
- The following OTC ear drops are effective for treating swimmer's ear:
Comparison of Effectiveness
- A study compared the effect of boric acid and polymyxin NH ear drops in the treatment of acute otitis externa, and found that both treatments had similar pain relief and effectiveness 4
- Another study compared the efficacy, safety, and pain relief of once-daily ofloxacin otic solution versus neomycin sulfate/polymyxin B sulfate/hydrocortisone otic suspension four times a day, and found that both treatments were equally effective and safe 5
Precautions and Risks
- Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided to prevent swimmer's ear 7
- People with recurrent ear disease should take special care when swimming in waters containing Pseudomonas aeruginosa 8
- Children with tympanostomy tubes can surface swim without taking water precautions, but should avoid diving and swimming more than 180 cm below the surface 6