From the Guidelines
The most effective treatment for swimmer's ear (otitis externa) is the use of eardrops alone, which may contain antibiotics, antiseptics, steroids, or a combination, as they are sufficient to treat the infection in most cases. According to the clinical practice guideline: acute otitis externa executive summary 1, eardrops are the primary treatment for acute otitis externa, and antibiotics taken by mouth are only necessary when the infection spreads beyond the ear canal, eardrops cannot get into the ear, or the immune system is weak.
The choice of eardrop depends on various factors, including cost, dosing frequency, status of the eardrum, and the doctor's experience, as well as the patient's preferences and medical history 1. It is essential to inform the doctor about any prior ear surgery, perforation of the eardrum, or ear tube placement, as this may affect the choice of eardrop.
Patients can expect to feel better within 48 to 72 hours of starting treatment, and symptoms should resolve within 7 days 1. If symptoms persist, it is crucial to notify the doctor and continue the eardrops until the symptoms resolve, for a maximum of 7 additional days.
To manage pain, analgesics like acetaminophen or ibuprofen can be used, especially in the first few days of treatment 1. It is also important to keep the ear dry by avoiding swimming and using earplugs or cotton balls coated with petroleum jelly when showering, and to avoid scratching or touching the ear and inserting anything into the ear canal.
Preventive measures, such as removing obstructing cerumen, using acidifying ear drops, drying the ear canal with a hair dryer, and using ear plugs while swimming, can help prevent acute otitis externa 1.
In terms of specific eardrop medications, all eardrops approved for treating acute otitis externa are highly effective, with no consistent advantage shown for any one specific drug 1. However, the most recent and highest quality study 1 does not specify particular medications, emphasizing the importance of individualized treatment based on patient factors and doctor's expertise.
Overall, the key to effective treatment of swimmer's ear is the use of eardrops, proper ear care, and prevention of further infection, with the goal of reducing pain, promoting healing, and preventing complications.
From the FDA Drug Label
Ciprofloxacin otic solution, 0.2% is a quinolone antimicrobial indicated for the treatment of acute otitis externa due to susceptible isolates of Pseudomonas aeruginosa or Staphylococcus aureus. The contents of one single-dose container (deliverable volume: 0. 25 mL) should be instilled into the affected ear twice daily (approximately 12 hours apart) for 7 days.
The treatment for swimmer's ear (otitis externa) is ciprofloxacin otic solution, 0.2%, which should be instilled into the affected ear twice daily for 7 days 2.
- The solution should be warmed before use to minimize dizziness.
- The patient should lie with the affected ear upward after instillation to facilitate penetration of the drops into the ear.
- Clinical cure was achieved in 70% of patients treated with ciprofloxacin otic solution, 0.2% in a clinical study 2.
From the Research
Treatment for Swimmer's Ear (Otitis Externa)
The treatment for swimmer's ear (otitis externa) includes:
- Frequent cleansing of the ear canal 3
- Pain control 3
- Oral or topical medications 3
- Acidification of the ear canal 3, 4
- Control of predisposing factors 3
Medications
Some effective medications for otitis externa include:
Prevention
To prevent otitis externa, it is recommended to:
- Avoid swimming in polluted waters 3
- Avoid ear-canal cleaning with cotton-tip applicators 3
- Use prophylactic measures such as desiccation and acidification of the canal 4
- Use protective and preventive medicinal preparations 7