Polysporin Ear Drops Are Not Appropriate for COVID-19 Related Ear Pain
Polysporin (neomycin and polymyxin B) ear drops should not be used for ear pain related to COVID-19 and sinus congestion, as this represents referred pain from upper respiratory inflammation rather than a bacterial ear infection requiring topical antibiotics.
Why Topical Antibiotics Won't Help Your Situation
Your ear pain is most likely referred pain from sinus congestion and upper respiratory inflammation, not a bacterial infection of the ear canal or middle ear. 1 Polysporin ear drops are antibiotics designed to treat bacterial infections of the external ear canal (otitis externa), not pain from sinus pressure or viral upper respiratory symptoms.
- COVID-19 commonly causes upper respiratory symptoms including nasal congestion (28.3% of patients), sore throat (30%), and headache (25%), which can all contribute to ear discomfort through eustachian tube dysfunction and referred pain. 1
- The ear pain you're experiencing is likely secondary to sinus congestion blocking the eustachian tube, creating pressure and discomfort, rather than an actual ear infection. 1
The Real Concern: Inappropriate Antibiotic Use
Using antibiotics when they're not indicated is actively harmful and goes against current medical guidelines:
- Guidelines strongly recommend against routine antibiotic use in COVID-19 patients unless there is clear clinical evidence of a bacterial superinfection. 2
- Antibiotics should only be prescribed based on "clinical justifications, such as disease manifestations, disease severity, radiographic imaging, and laboratory data"—not just symptoms like ear pain. 2
- The COVID-19 pandemic has already contributed to increased antibiotic resistance due to inappropriate antibiotic prescribing, and stewardship remains critical. 3
What Actually Causes Bacterial Ear Infections in COVID-19 Patients
When true bacterial ear infections occur in COVID-19 patients, they typically present differently:
- Acute otitis media with complications (like facial paralysis, severe pain with fever, or purulent drainage) would warrant evaluation and potentially systemic antibiotics—not topical ear drops. 4
- Post-COVID bacterial sinusitis can occur, particularly in patients who received prolonged steroid therapy, but this requires systemic antibiotics and proper diagnostic workup, not topical ear drops. 5, 3
What You Should Do Instead
For symptomatic relief of ear pain from sinus congestion:
- Oral decongestants and nasal saline irrigation can help relieve eustachian tube dysfunction and reduce referred ear pain
- Oral anti-inflammatory medications (ibuprofen or acetaminophen) will address both pain and inflammation more effectively than topical antibiotics
- Warm compresses applied to the affected ear can provide comfort
- Nasal corticosteroid sprays may help reduce upper airway inflammation if congestion persists
When to Seek Medical Attention
You should see a healthcare provider if you develop:
- Fever ≥38°C (100.4°F) accompanying the ear pain 2
- Purulent drainage from the ear canal 4
- Severe, worsening pain despite symptomatic treatment 1
- Hearing loss, dizziness, or facial weakness 4
- Symptoms persisting beyond 7-10 days 5
These would suggest a true bacterial superinfection requiring proper evaluation and potentially systemic antibiotics, not topical ear drops.