From the Guidelines
For Staphylococcus aureus ear infections, ear drops containing framycetin, neomycin, sulfacetamide, and gramicidin are effective, as they provide broad-spectrum coverage against Staph aureus and other common pathogens. These ear drops are typically prescribed as 2-3 drops in the affected ear 2-3 times daily for 7-10 days 1. It is essential to clean the outer ear gently and lie with the affected ear upward for 3-5 minutes after application to ensure the medication penetrates properly. Pull the outer ear gently upward and backward (for adults) or downward and backward (for children) to straighten the ear canal during administration.
- Key considerations for managing acute otitis externa include:
- Identifying patients with underlying conditions that may affect treatment, such as diabetes or immunocompromised states 1
- Avoiding the use of topical antibiotics in patients with suspected otomycosis, as they can promote further fungal overgrowth 1
- Considering the use of systemic antimicrobials in patients with severe infections or those who do not respond to topical therapy 1
- If symptoms do not improve within 48-72 hours, or if you experience increased pain, fever, or drainage, seek medical attention as oral antibiotics may be needed 1.
- It is crucial to follow the prescribed treatment course and attend follow-up appointments to ensure complete resolution of symptoms and prevent potential complications.
From the Research
Ear Drops Effective Against Staphylococcus aureus Infections
- The ear drops in NZ that contain framycetin, neomycin, sulfacetamide, and gramicidin are effective against Staphylococcus aureus (Staph aureus) infections 2, 3.
- Studies have shown that sulfacetamide ototopical medication can be effective in treating MRSA-related tympanostomy tube otorrhea 3.
- Neomycin and polymyxin B have been shown to be effective against Staphylococcus aureus, but there is evidence of declining susceptibility to these antibiotics 4.
- Gentamicin sulfate has been shown to be effective against MRSA in combination with oral trimethoprim-sulfamethoxazole 2.
- Fluoroquinolone ototopical medications, such as ofloxacin, have been shown to be effective in treating MRSA-related tympanostomy tube otorrhea 3.
Considerations for Treatment
- It is essential to obtain cultures from patients with nonresponsive or persistent otorrhea with AOM to look for MRSA and determine the sensitivity of the pathogen to antibacterial therapy 2.
- The use of ear drops containing neomycin, gramicidin, and dexamethasone can cause severe deafness and vertigo, especially in patients with perforated tympanic membranes or grommets 5.
- Tympanostomy tube removal may be necessary in some cases of MRSA-related tympanostomy tube otorrhea 3.