From the Guidelines
Half-strength acetic acid (vinegar) can be used as a preventive measure for otitis externa (swimmer's ear), but it should not replace proper medical treatment for an active infection. The use of acidifying ear drops, such as half-strength vinegar, is recommended as a preventive measure for acute otitis externa (AOE) 1. To use it preventively, mix equal parts white vinegar and distilled water, then place 3-5 drops in each ear after swimming or bathing. Allow the solution to remain in the ear for about 30 seconds before draining. The acidic environment created by the vinegar helps prevent bacterial and fungal growth by restoring the ear canal's natural acidic pH, which is disrupted by water exposure. This works because most pathogens that cause otitis externa thrive in alkaline environments.
Some key points to consider when using half-strength vinegar as a preventive measure include:
- Removing obstructing cerumen to prevent AOE 1
- Using acidifying ear drops shortly before swimming, after swimming, at bedtime, or all three 1
- Drying the ear canal with a hair dryer 1
- Using ear plugs while swimming 1
- Avoiding trauma to the external auditory canal 1
For active infections, however, medical treatment with prescription antibiotic or antifungal ear drops is necessary, especially if there's significant pain, discharge, or hearing loss, as stated in the clinical practice guideline for acute otitis externa 1. Never use vinegar solutions if you have ear tubes, a perforated eardrum, or if there's drainage from the ear, as this could cause serious complications.
From the Research
Treatment Options for External Otitis
- Half-strength acetic acid (vinegar) can be used as a treatment option for external otitis, as it has antimicrobial properties 2.
- Topical antimicrobials or antibiotics, such as acetic acid, are the treatment of choice in uncomplicated cases of external otitis 2.
- The choice of treatment is based on several factors, including tympanic membrane status, adverse effect profiles, adherence issues, and cost 2.
Effectiveness of Acetic Acid
- There is no direct comparison of half-strength acetic acid to other treatment options in the provided studies.
- However, acetic acid is mentioned as a treatment option for external otitis, suggesting its potential effectiveness 2.
Comparison to Other Treatment Options
- Neomycin-polymyxin B association has been shown to have synergic effects against pathogens commonly responsible for otitis externa 3.
- However, the susceptibility of pathogens to neomycin and polymyxin B has been declining over time 4.
- Ciprofloxacin has been shown to be effective in the treatment of otitis externa, with rapid eradication of bacterial pathogens 5.