From the Research
Recurrent adult ear infections should be treated with a combination of antibiotics, pain management, and preventive measures, prioritizing amoxicillin-clavulanate for more resistant cases, as evidenced by the most recent and highest quality study 1.
Treatment Approach
The treatment of recurrent ear infections in adults involves a multifaceted approach, including:
- Antibiotics: Amoxicillin (500-875 mg twice daily for 5-7 days) is typically the first-line treatment, with amoxicillin-clavulanate (875/125 mg twice daily for 5-7 days) used for more resistant cases, as supported by 1.
- Pain Management: Over-the-counter medications like acetaminophen or ibuprofen can be used to manage pain.
- Preventive Measures: Keeping ears dry after swimming or bathing by tilting your head to drain water and using a hair dryer on low setting can help prevent recurrence.
Specific Considerations
- For otitis externa (swimmer's ear), antibiotic ear drops like ciprofloxacin-dexamethasone (4 drops in affected ear twice daily for 7 days) are recommended.
- Avoid inserting objects into the ear canal, including cotton swabs.
- If you have allergies, managing them with antihistamines or nasal steroids may help prevent ear infections.
- Recurrent infections warrant evaluation by an ENT specialist to rule out underlying issues like immune deficiency, anatomical abnormalities, or chronic conditions.
- Smoking cessation is also important as it can contribute to Eustachian tube dysfunction and increased infection risk, as noted in 2.
Evidence Summary
The most recent and highest quality study 1 demonstrates the efficacy of amoxicillin-clavulanate in treating bacterial acute otitis media, including cases caused by penicillin-resistant S. pneumoniae and beta-lactamase-positive H. influenzae. This study supports the use of amoxicillin-clavulanate as a first-line treatment for recurrent ear infections in adults.