Antibiotics for otitis media

Otitis is an acute or chronic inflammatory process in various ear zones (external, middle or internal). Antibiotics for otitis are prescribed without fail, based on the severity and stage of the process, the sensitivity of microorganisms, the degree of development of clinical symptoms, and the age of the patient.

Previously untreated ear diseases require the prescription of stronger antibiotics. Sometimes it is necessary to use not one, but several types of antibacterial agents if the pathological process is in an advanced stage.

Let us consider the advisability of antibiotic therapy for inflammatory diseases of the ear.

[ 1 ], [ 2 ]

Are antibiotics necessary for otitis?

Antibiotic therapy is very important in the development of inflammatory processes. However, many specialists are of the opinion that until the spontaneous perforation of the ear membrane and the release of exudative fluid, there is no need to prescribe antibiotics. The acute stage of uncomplicated otitis usually passes within 5 days. Antimicrobial therapy is connected in cases when symptomatic treatment of catarrhal otitis does not bring relief to the patient: ear pain does not go away, hearing acuity worsens, there are signs of general intoxication of the body.

When purulent discharge appears, an analysis is taken to determine the microflora content and its sensitivity to antibiotics. If it is not possible to access the exudate, a puncture is made to take samples of the contents of the ear, or they get by with the prescription of broad-spectrum antimicrobial drugs.

Prevention of complications, especially in patients with low immune protection, may also serve as an indication for the appointment of antibiotic therapy.

[ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ]

What antibiotics should I take for otitis?

The most popular remedy is amoxicillin, which has excellent antimicrobial and antiseptic effects. If the patient is not allergic to semisynthetic penicillins, it can be successfully prescribed at any stage of the inflammatory process. However, this drug is contraindicated for patients with impaired liver function, during pregnancy and breastfeeding.

Aminoglycoside netilmicin is a drug for local injection use, used for no more than 14 days in a row. It has good therapeutic indicators and a minimum of side effects.

The question of prescribing medications is decided by the doctor individually after the results of tests on the microflora of the discharge.

If it is impossible to check the sensitivity of microflora to the action of antimicrobial agents, broad-spectrum drugs are prescribed:

• chloramphenicol, alcohol solution. Use 2-3 drops for purulent otitis;
• amoxicillin 3-3.5 grams per day;
• augmentin 375 mg 3 times a day;
• cefuroxime intramuscular injection;
• ceftriaxone once daily;
• ampicillin intramuscular injection.

The addition of antibiotics to the otitis treatment regimen significantly reduces the likelihood of complications and improves the prognosis of the disease.

Antibiotics for otitis in children

Immediately before prescribing any medications to a child, it is necessary to assess his general condition and determine further treatment tactics.

If signs of otitis are detected in a child, do not rush to prescribe antibiotics. They are used only in severe, moderate and complicated cases of the disease, especially in children under 2 years of age, when the immune system is still in the developmental stage.

In case of a mild inflammatory process in older children, it is usually enough to eliminate the clinical manifestations of the disease, use analgesics, ear drops, compresses, ointments, lotions. But if there is a characteristic picture of general intoxication of the body, there is a high temperature, persistent headaches - you cannot do without antibiotics. In such cases, the sick child is subject to hospitalization, where the doctor decides on further use of drugs. Usually, preference is given to the well-known and effective antibiotic amoxicillin. However, if within two days from the moment of taking the child's health has not improved, another drug is prescribed, for example, from the cephalosporin series.

During antibiotic treatment, the prescribed dosage should be strictly followed throughout the entire prescribed course, even in cases of persistent improvement in the patient's general condition. Due to an unmotivated reduction in dosage, weakened but living bacteria may gain new strength, and then the inflammatory process will flare up again.

[ 9 ]

Antibiotics for otitis in adults

Otitis in adults often has an infectious etiology. Therefore, antibacterial drugs are used quite often, along with analgesics and anti-inflammatory drugs, with warming procedures and washing with antiseptic agents.

The type of antibiotic prescribed is determined by the type of infection present in the ear. In severe cases, several types of antibiotics may be used simultaneously, for example, orally and as intramuscular injections.

In acute cases of otitis media, antibiotics are prescribed without fail: amoxicillin, amoxiclav, doxycycline, rovamycin. The drugs are prescribed in the form of tablets and capsules for internal use, and in severe and unfavorable cases of the disease, intramuscular or intravenous injections are used.

Antibiotic therapy is prescribed with caution to elderly people and is strictly contraindicated for women during pregnancy and breastfeeding.

[ 10 ], [ 11 ], [ 12 ], [ 13 ]

Antibiotics for acute otitis

Acute otitis is characterized by a sharp increase in symptoms, a rapid deterioration in the general well-being of the patient - excruciating pain in the ear, radiating to the entire half of the head and teeth, a rapid rise in body temperature to 39 degrees.

Antibacterial agents applied locally, in the form of drops and ointments, are very effective in such situations. But in many cases, there is a need to take systemic drugs. Combined antibiotics have a wider spectrum of action, high functional activity. Such combinations of drugs as neomycin + bacitracin, polymyxin + hydrocortisone have high efficiency rates.

For the treatment of acute otitis, any of the broad-spectrum antibiotics can be used, which have a pronounced bactericidal effect and restore the natural slightly acidic environment of the ear canal. The most acceptable are semi-synthetic penicillin preparations that are resistant to beta-lactamases (oral dicloxacillin or intravenous oxacillin, also a group of cephalosporins).

[ 14 ], [ 15 ], [ 16 ]

Antibiotics for chronic otitis

Chronic otitis usually develops as a result of improper or untimely treatment of acute inflammation.

Chronic otitis is characterized by a wide variety of pathogens, mixing of different types of bacteria in the exudate, which significantly complicates the choice of antibiotic and the appointment of a general treatment regimen. Destruction of polymicrobial flora requires the use of stronger drugs, sometimes their combinations.

In case of long-standing and difficult to treat chronic forms of otitis, such medications as sparflo (orally 400 mg at first, 200 mg daily in the following days), avelox at a dose of 400 mg daily in one go are prescribed. The course of treatment should last from 10 to 14 days, with mandatory background intake of antifungal and microflora-normalizing drugs and vitamin complexes.

Ciprofloxacin is a fluoroquinolone antibiotic that is especially popular in medical institutions in European countries. This drug is good because it has a destructive effect on both active and immobile bacteria. It is taken on an empty stomach three times a day, the maximum daily dose is 750 mg.

[ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ]

Antibiotics for otitis media

Otitis media is the most common form of otitis and is an inflammatory process in the middle ear.

Antibiotic therapy is usually prescribed when complications develop, the disease is protracted, and fluid is present in the ear cavity. The most suitable drug is selected based on the patient's allergy sensitivity, condition, and age. If it is impossible to determine which pathogen caused the disease, a systemic antibiotic is prescribed that acts on a wide range of the most common pathogens of otitis (pneumococcal infection, Haemophilus influenzae, Moraxella, etc.).

Most often, amoxicillin is preferred for the treatment of otitis media. The usual dosage for adults is 3 g daily, three times a day. Children take 85 mg per kg of body weight per day.

If the clinical picture does not improve after 2-3 days, it is necessary to replace this antibiotic with a stronger combination drug - for example, amoxiclav, cefuroxime.

[ 22 ], [ 23 ], [ 24 ], [ 25 ]

Antibiotics for purulent otitis

The development of purulent otitis is characterized by a rupture of the internal membrane and the release of purulent contents to the outside.

During this period, it is advisable to prescribe rinsing with antimicrobial agents (without ototoxic effect, i.e., not suppressing the auditory function), introduction of combined antibiotic solutions into the ear cavity. Such procedures are carried out exclusively in a hospital or clinic by an otolaryngologist.

General therapeutic methods for purulent otitis do not differ from those for a standard inflammatory process. Antibacterial therapy is carried out with complex drugs erythromycin, clarithromycin, amoxiclav, ceftriaxone. In the development of complications and a long course of the disease, non-steroidal anti-inflammatory drugs (diclofenac, olfen) are connected. The well-known first-generation drug ampicillin remains popular, although it is more rational to use newer drugs - amoxicillin (flemoxin, ospamox).

[ 26 ], [ 27 ], [ 28 ], [ 29 ], [ 30 ]

Antibiotics for otitis externa

External otitis affects the skin of the ear, the outer zone of the auditory canal and the periosteum, which is located just under the skin. If it is not possible to examine the condition of the eardrum and exclude a deeper spread of the process, treatment is prescribed simultaneously for both external and internal otitis.

The main point in the treatment of otitis externa is the use of antibiotics in the form of ear drops (ofloxacin, neomycin). You can also use a cotton swab with antimicrobial ointment or antibiotic solution, inserted deep into the ear canal. Such a swab should be changed every 2.5 hours throughout the day.

It is necessary to include additional treatment methods, such as warming compresses, vitamin therapy, and support of intestinal microflora.

Most often, there is no need to prescribe antimicrobial agents when treating external otitis. Antibiotic therapy is carried out only in cases of complications, or in patients with critically weakened immune forces of the body.

[ 31 ], [ 32 ], [ 33 ], [ 34 ]

Ear drops with antibiotic

Drops used to treat ear inflammation are usually very effective, as they are administered directly to the site of inflammation. They can be of several types:

• hormonal anti-inflammatory drugs (otinum, otipax);
• antibiotic solutions (levomycetin, normax, cipromed, fugentin);
• combination solutions that combine the action of an antibiotic and a glucocorticoid (sofradex, anauran, polydex, garazon).

The drug Anauran is applicable for all types of acute and chronic forms of otitis, and is used by adults and children 3-5 drops three times a day.

Sofradex drops can be used for therapeutic purposes for otitis and conjunctivitis, have a strong anti-inflammatory and anti-allergic local effect.

Drops, as a rule, have a fairly broad spectrum of action. They are used locally, 4 drops twice a day in the affected ear, for children 2-3 drops three times a day.

Ear drops containing corticosteroids should be used with caution in small children and pregnant women.

If there is a suspicion of an allergic reaction (swelling of the auricle, rash, itching), the use of drops is stopped, and the doctor reviews the treatment regimen and replaces the drug with a more suitable one.

[ 35 ], [ 36 ], [ 37 ], [ 38 ]

The best antibiotic for otitis

The best antibiotic for otitis is determined by the results of the analysis of microflora. As for broad-spectrum drugs, amoxicillin should be especially noted, which is most often used in medical practice for various types of otitis and in most cases has a positive therapeutic effect in all age groups.

Amoxicillin belongs to the penicillin series of antibiotics and inhibits the action of most harmful microorganisms: streptococci, staphylococci, E. coli, etc.

The drug is taken orally separately from meals, 0.5 g 3 times a day, in complicated cases up to 3 g per day. The duration of taking amoxicillin, like any other antibiotic, is at least 8-10 days. Even with a noticeable improvement in the patient's well-being and the disappearance of clinical symptoms, treatment is continued until the specified period. Untimely withdrawal of antimicrobial drugs can provoke a relapse of the inflammatory process, and in a more severe form.

How to cure otitis without antibiotics?

Therapeutic actions in case of uncomplicated otitis may not include the prescription of antibiotics. Sometimes conservative complex treatment of the inflammatory process is more than enough:

• if necessary, antipyretic drugs (aspirin, paracetamol) are prescribed;
• three times a day, the drug Otipax - 2 drops in the sore ear;
• use of a nasal spray to relieve swelling of the mucous membrane (Nazivin, Noxprey, etc.);
• change ear tampons with a medicinal substance (boric alcohol, vodka, onion juice) at regular intervals;
• in case of external otitis, lubricate the ear and the surrounding area with a bactericidal agent;
• in case of inflammation you should drink a lot of fluids, as with a cold (raspberry, currant, rosehip, linden tea);
• provide the patient with rest and ensure there are no drafts.

At the first signs of otitis, you can try to use folk methods of treating the disease. Even those plants that grow directly in the house, on the windowsill, can be useful: aloe, kalanchoe, agave, geranium. A freshly picked leaf or part of it is rolled into a turunda and inserted into the sore ear. You can squeeze the juice out of the plants and drip 3-5 drops into the sore ear.

You can also use a warm solution of honey, celandine juice, mint tincture, or boric alcohol as drops.

During treatment, you should drink plenty of fluids; it would not be a bad idea to take multivitamin complexes, as well as immune-boosting medications.

If the patient's condition clearly worsens, it is still necessary to consult a doctor in order to prevent further progression of the disease and the development of complications.

To avoid inflammation in the ear area, remember that in the cold season it is unacceptable to go outside without a hat, especially not immediately after taking a shower or bath. After visiting the pool or swimming on the beach, it is necessary to dry your ears well, not allowing water, especially dirty water, to remain in the ear canals for a long time.

If the disease does occur, it is best to carry out treatment under the supervision of a specialist who will prescribe you the appropriate treatment and necessary antibiotics for otitis.