How to treat acute and chronic purulent otitis in adults?

Local treatment includes the use of drops - to relieve pain, to improve the yield of the pathological mass, to reduce swelling of inflamed tissues.

The general treatment consists in antibiotic therapy: the drugs are taken orally, injected, and also dripped in the form of drops after a breakthrough of pus.

To reduce the severity of the inflammatory reaction, often prescribed drugs such as Nurofen, Ibuprofen, Diclofenac.

How many are treated with otitis media? Standard treatment is carried out for about seven or ten days. However, sometimes the therapy can be delayed - for example, with the development of complications, or with weakened immunity in the patient.

With the onset of suppuration, a regular ear toilet is performed with purulent otitis. The affected ear canal is cleaned with a cotton pad dipped in hydrogen peroxide, and then begins cleaning the auditory passage. Doctors recommend conducting such a procedure in out-patient conditions, with the help of a manipulative sister. The fact is that too careless and deep cleaning can lead to damage to the membrane. The auditory passage is cleaned without excessive pressure, using cotton wool, impregnated with an isotonic solution of sodium chloride or hydrogen peroxide.

After holding the toilet of the ear in the cavity can be dripped prescribed by the doctor preparations - for example, solutions of furacilin or sulfacil sodium. Some patients are prescribed to drip into the ear. Protargol is a long-time proven drug that accelerates the healing of the damaged membrane.

Ear washing with purulent otitis

Washing of the affected ear is carried out at home, or in a polyclinic. For washing, various solutions of antiseptics can be used - for example, furacilin, hydrogen peroxide, a weak solution of potassium permanganate, or ordinary saline solution.

• How is washing done at home?

Heat the wash solution to body temperature. Collect the heated solution in a syringe, remove the needle, tilt the patient's head so that the affected ear is on top. Pour into the ear cavity 1 ml of the drug, then tilt the ear so that the liquid poured out of it onto the framed shawl or napkin. So repeat several times. After the procedure, the ear should be dried with a clean cloth. If necessary, immediately dribble prescribed medications.

• How is it conducted in a polyclinic or in a hospital?

The patient sits on the couch, struck with an ear toward the nurse. To the ear is attached a special curved tray into which the wash solution will flow. The nurse fills the large syringe with a warm solution, injects this solution into the ear so that it drips over the surface of the back wall. After the administration of the entire solution, the patient tilts his head to allow all the liquid to flow into the tray. Next, the nurse wet the ear with a napkin and, if necessary, conducts other medical manipulations.

[1], [2], [3], [4], [5]

Medications

The main drugs used in the treatment of pyoinflammatory processes in the ears of adults are:

• Glucocorticosteroids - hormonal agents (for example, Prednisolone) - eliminate edema, contribute to the speedy completion of the inflammatory process.
• Antibiotics - in the form of injections, tablets, capsules, ear drops. Most specialists start therapy with penicillin group drugs, or cephalosporin group. Drugs of the second choice can be macrolides - for example, Azithromycin. Do not use with purulent otitis such antibiotics as aminoglycosides - because of their toxicity to the hearing organs.
• Antiallergic drugs - they are prescribed when purulent otitis is preceded by allergic rhinitis or other types of allergies. In such a situation it is appropriate to administer Suprastin, Clemastin, etc.
• Vasoconstrictive means - used to reduce swelling, to extend the patency of the auditory tube. For these purposes, Naphthyzin, Sanorin and other similar preparations are suitable.

Some of the medicines should be considered in more detail:

• Otofa with purulent otitis is appointed because of the pronounced antimicrobial activity. The active ingredient is rifampicin, which affects most gram (+) and gram (-) microorganisms, which can cause inflammation in the ear. Otofa drops are dripped daily, in the mornings and evenings, five drops each in the patient's auditory passage.
• Otipax with purulent otitis has a combined effect, as it contains a couple of active ingredients - it's phenazone and lidocaine. Thus, Otipax has a strong analgesic and anti-inflammatory effect - therefore, it is used in the pre-perforation stage. Normally drip 4 drops of the drug up to 3 times a day, into the affected auditory motion. The duration of therapy is 7-10 days, not more.
• Dioxydin with purulent otitis is prescribed only to adult patients. Dioxydin is an antimicrobial agent with a wide spectrum of activity. It acts even on such types of microorganisms that are insensitive to certain antibiotics, sulfonamides, nitrofurans, etc. The drug is washed with a sick ear cavity, using 10 ml of a 1% solution. Since Dioxydin can cause allergic reactions, after the first wash after the patient is observed for 5-6 hours, and only after that continue therapy. The standard course duration is 20 days, but sometimes the treatment can take up to 4-6 weeks.
• Miramistin with purulent otitis is used as an effective antimicrobial agent. With purulent otitis in adults, turunda is moistened in Miramistin and injected into the auditory canal up to six times a day. Course therapy lasts up to 2 weeks.
• Ceftriaxone in purulent otitis can be used to stop the inflammatory process, as well as to prevent and eliminate complications. The drug is a powerful antibiotic, so it should not be used in women during pregnancy. Standard Ceftriaxone is prescribed for 1-2 g daily. The duration of the course is determined by the doctor.
• Anauran with purulent otitis shows simultaneous antimicrobial and anesthetic action, and also has an antimycotic effect, which makes it possible to use the drug to combat otomycosis. Anauran is dripped into the ear canal until the moment of perforation, since subsequently the solution is capable of exerting ototoxic effect. At the pre-perforating stage, 5 drops of the solution drip 4 times a day, for no more than 10 days. In rare cases, skin irritation may occur if you use Anauran.
• Ampicillin from purulent otitis often turns out to be a first-line preparation. This drug is a representative of semisynthetic penicillins, has a broad spectrum of antimicrobial activity. Ampicillin is given as an intramuscular injection, 0.5 g once every 7 hours. The duration of the course is determined by the doctor. It is noted that in some patients after the application of Ampicillin, indigestion, pain in the head, as well as soreness in the zone of drug administration are observed.
• Boric alcohol in purulent otitis dripping directly into the ear canal 3 drops three times a day, but only until the moment of perforation of the membrane. Then use the drug can not. Boric alcohols are also treated with cotton flagella, which are then introduced into the auditory passage at night. What kind of treatment to choose, the doctor decides at the reception. In the absence of the effect of boric alcohol, it is recommended to switch to more powerful drugs.
• Supraks with purulent otitis represents antibiotics of the cephalosporin group - it is a semi-synthetic drug with a pronounced bactericidal effect. The dose of Suprax is 400 mg per day, for 1-2 doses, regardless of the time of meal. The duration of antibiotic therapy depends on the severity of purulent inflammation and the type of pathogen. As side reactions, candidiasis, skin rashes, headaches and dyspepsia are most often recorded.
• Polidexa with purulent otitis is prescribed in case the membrane is not damaged - for example, with an infectious lesion of the external auditory canal. Polydex is a combination of a corticosteroid and an antimicrobial component. Before applying these drops, it is necessary to ensure the integrity of the membrane, since if there is damage, serious complications may develop - in particular, hearing loss, vestibular apparatus disorder may occur. The dosage of Polidex is 2-5 drops in each ear loop in the mornings and at night. The average duration of therapy is one week.
• Cipromedum with purulent otitis is prescribed when the disease has no viral etiology and can not be treated with other antibiotics. Zipromed contains 0.3% ciprofloxacin, a second generation fluoroquinolone agent. The standard dosage of the drug is five drops three times a day for 7-10 days.
• Zinnat with purulent otitis appoint for oral administration. The effect of the drug is based on the effect of the main ingredient of cefuroxime, a representative of cephalosporin antibiotics. Zinnat is not used if the patient has previously been allergic to penicillins, monobactams and carbapanemes. The average dosage of the drug is 250 mg twice a day, with food, for a week.
• Azithromycin in purulent otitis is prescribed to adult patients according to this scheme: on the first day, 500 mg should be taken, from the second to the fifth day, 250 mg / day. The total amount of the drug per course is 1.5 g. Azithromycin belongs to macrolide antibiotics, it is available in the form of capsules. Among the most common side effects can be distinguished dizziness, abdominal pain, candidiasis, vaginitis.
• Levomekol with purulent otitis can be used only until the breakthrough or incision of the membrane. Application of the ointment is carried out 1-2 times a day, for 3-10 days. To apply the drug used gauze turunda, which is processed with ointment and inserted into the ear for about seven hours. Levomekol contains a couple of active ingredients - chloramphenicol and methyluracil. Their action is manifested in a complex: the antibacterial effect is supplemented by the strengthening of the immune defense at the local level, which contributes to the rapid healing of tissues.
• Amoxiclav with purulent otitis often becomes a drug of choice. It is a polysynthetic antibiotic with a broad spectrum of activity, containing two active ingredients - amoxicillin and clavulanic acid. Contraindication to the use of the drug is a tendency to allergies to drugs of the group of penicillins, cephalosporins, carbapanemes. Adult patients with purulent otitis appoint 125-500 mg of the drug three times a day, depending on the severity of the disease. Therapy can last no more than 2 weeks.
• Otirelaks with purulent otitis has an anti-inflammatory and analgesic effect, as it consists of a combination of components such as phenazone and lidocaine. Drops of Otirelaks apply only with the whole membrane, in the preperforative stage. Drops drip into the outer ear canal for 3-4 drops, up to 3 times a day. Duration of application - no more than 7-10 days. After perforation and exit of pus, the use of Otirelaks is prohibited.
• Danzil with purulent otitis acts bactericidal - due to the component of ofloxacin. Danzil is prescribed for external otitis, with a chronic form of purulent otitis, including perforation of the membrane. Dancil should not be used to treat children and women during pregnancy. Standard for purulent otitis in adults drip 10 drops of medication in the patient's auditory passage twice a day, for 2 weeks. To prevent dizziness, the solution should be warmed to body temperature before use.

Antibiotics for purulent otitis

With the formation of pus in the ear are often resorted to using semisynthetic drugs and so-called protected penicillins. These include Amoxiclav, Amoxicillin. Analogues of the listed drugs are Azithromycin, Cefuroxime, Ciprofloxacin.

Injections with purulent otitis can also contain antibiotics. In most cases, these are the groups of medicines:

• fluoroquinolone series, is represented by Ofloxacin, Ciprofloxacin;
• β-lactams are represented by Imipenem, Meropenem;
• cephalosporin series, is represented by Cefotaxime, Ceftriaxone;
• a number of protected penicillins (eg, Co-amoxiclav).

Injections of β-lactams and antibiotics-fluoroquinolones are left for the "extreme" case - they are prescribed for severe forms of inflammation, with a high probability of complications.

[6], [7], [8], [9], [10], [11], [12], [13],

Drops with purulent otitis

Drops are considered essential for the treatment of inflammation with the formation of pus in adults. However, not all ear drops can be used at any stage of inflammation. Let us consider this in more detail.

• Until the moment of the rupture (cut) of the membrane, drops with analgesics are used, for example:
  • Otisol;
  • Otinum;
  • Otypaks.

Antimicrobial drops at this stage are inappropriate, since they will not be able to show their action due to the presence of a barrier in the form of a membrane.

• After a perforation, drops with analgesics are not used: they can damage the snail receptors. At this stage, antibiotic alternatives come in - they are buried in the diseased ear, considering the resistance of bacteria. But there are also some limitations: ototoxic preparations such as gentamycin, polymyxin B, alcohol solutions, choline and phenazone can not be used.

Optimal for the selection of antimicrobial agents are Miramistin, Ciprofarm, Normax and others.

[14], [15], [16], [17]

Compresses with purulent otitis

Compression - hot or cold, with pyo-inflammatory processes in the ear is prohibited. The fact is that the effect of compress can lead to the spread of damage to surrounding tissues, as well as to the breakthrough of the pathological mass not through the membrane but into the cranial cavity.

Compresses and any warming procedures are performed only with acute otitis in the early stage of the disease, provided there is no high temperature and visible damage to the skin.

[18], [19], [20]

Ointments with purulent otitis

It is generally considered that ointment for otitis is simply necessary. But this has nothing to do with the inflammatory release of pus in adults - if the doctor has not prescribed any ointment, then the independent use of such drugs is not welcome at all. All external preparations have different composition and different effects. In this purulent-inflammatory process proceeds through the stages, and ointments will not help in all of them (and sometimes even can do much harm).

For example, the popular ointment of Sofradex in purulent otitis can be applied only to the stage of perforation. The ointment is applied to a small cotton wool turunda and put into the ear for a quarter of an hour, and no more than half an hour. You can not insert a turund deeply.

Ointment Vishnevsky also applies only at an early stage of otitis. With the onset of a purulent process, the ointment should be discontinued.

Vitamins

With the development of inflammation with the release of pus, patients often lose their appetite and consume scanty food. However, it is during the illness that it is necessary to supply the body with vitamins and other useful substances as much as possible. In the diet should be present foods containing in sufficient quantities ascorbic acid, vitamin A, as well as various trace elements.

Citrus and kiwi contain a lot of ascorbic acid, which can correct the immune defense in the body. If to eat is especially reluctant, it is recommended, at least, to drink fresh orange juice, or water with lemon juice. Tomato and carrot juice will also benefit.

When preparing dishes, it is desirable to add natural antibiotics - onions and garlic. This will help to cope with the infectious process.

When ear inflammation is recommended to eat foods that reduce the amount of secreted mucus, as well as those that strengthen immunity. Such products include:

• any greenery;
• Bulgarian pepper;
• citrus fruits;
• chicken bouillon;
• real honey;
• kiwi;
• any berries;
• carrot;
• ginger root;
• beet;
• nuts, beans.

Physiotherapeutic treatment

Physiotherapy is especially needed as an integrated approach in the treatment of inflammatory otorrhoea in adults. At the same time, UHF and laser treatment, UFO, and solux are the most popular. These procedures will help to speed up blood circulation in the affected organ, stop the inflammatory process and strengthen immunity. In addition, such procedures help trigger recovery reactions.

For example, UHF treatment is prescribed for 5 sessions at the initial stage of otitis, and with the formation of pus - 10-15 sessions. With the outflow of pus, sessions become longer, to speed up the reparative processes. Plates are placed on the side of the back of the nose, opposite the affected ear.

Can I warm my ear with purulent otitis? It is not advisable to heat the ear with the formation of pathological discharge in it, as this can lead to the penetration of infection into the nearest tissues, as well as to the intracranial pus penetration. Such processes threaten serious complications, therefore the ear should not be warmed up with a purulent-inflammatory process.

Darsonval with purulent otitis only applies when the doctor insists on these procedures. Darsonvalization should be used very carefully, so the doctor determines the session schedule individually. A direct contraindication to such treatment is high body temperature.

• The bioptron lamp apparatus with purulent otitis is not used - it is used only with weak ear pains without the secretion of pathological discharge. With general pathologies, the Bioptron is prescribed more often for colds, arthritis, polyarthrosis, etc. Do not start the treatment with the device without consulting a doctor - this can lead to negative consequences.

Alternative treatment at home

Testing recipes for alternative medicine is allowed only with the permission of a doctor who considers such treatment safe. The bottom line is that a purulent-inflammatory process often entails the development of various complications, and quite serious ones. Therefore, the use of alternative methods often leads to a loss of time during which complications can occur. Ask your doctor: he will assess the situation and point out the possibility of using such a treatment.

Alternative healers offer such available remedies for inflammatory suppuration from the ear in adults:

• Grind the rhizomes of raspberries, separate three tablespoons of raw material and brew it in one liter of boiling water. Next, insist throughout the night and drink twice a day for 500 ml. Admission should continue for 4 weeks.
• Lower gauze turunda in 20% tincture of propolis, put in the ear. Hold in the ear canal the maximum possible amount of time. Treatment can last up to one month. The same prescription can be used to get rid of mesotympanitis.
• Put a gauze ball, impregnated with fresh cabbage juice, or a gauze knot in which there is a crushed cake of cabbage leaf. This procedure is best done at night.

It is also possible to use more simple recipes:

• Chew every morning for a quarter of a lemon, along with peel.
• Take 18-22 drops of pion tincture with water, morning, afternoon and night.
• Put a compress on the area around the ear, using 70% tincture of calendula. Duration of retention of the compress - 2 h.
• Wet gauze turunda in freshly squeezed juice of the bulb, squeezed and injected into the ear canal. Top with a scarf. Hold 1-2 hours.
• The juice of the horseradish rhizome drips into the ear 3 drops each. Alternatively, you can use the leek powder juice.
• Before going to sleep, a turunda, impregnated with 2.5% mumiy, is placed in the affected ear. Tampons may be replaced several times a day.

Especially popular is sea buckthorn oil from purulent otitis. Drip one drop of oil and the same amount of liquid honey into the affected ear canal, after which it is necessary to cover the ear with a cotton swab for about an hour. This procedure is carried out daily - for 1-4 months, depending on the course of purulent otitis media.

[21], [22], [23], [24]

Herbal Treatment

• Prepare a medical collection of plants such as the turn, yarrow, calendula, leaves of plantain and eucalyptus, pine buds, rhizomes of licorice. 1 tsp. Collect 200ml of boiling water, stand half an hour under the lid, after which take a little during the day. Duration of admission - up to six months.
• Before the perforation is recommended to drip into the ear tincture of eucalyptus, mint leaves, chamomile, leaves of plantain or calendula - 6 drops in the morning, afternoon and night.
• Take inside 5% tincture celandine - five drops in the water, for a week. As an analog it is allowed to use tincture of the pericarp of walnuts.

Bay leaf with purulent otitis

Drops based on bay leaves are prepared using vodka and vinegar. The proportional composition is as follows:

• 60 ml of vodka;
• 2 ml of normal table vinegar;
• Ground laurel leaf on the tip of the knife.

All the ingredients are mixed, aged for 2 weeks. The course of therapy should last 6-8 weeks. First, drip into the patient's ear a drop of this drug, then gradually bring the dose to 3 drops, and then again reduce the amount to 1 drop, and so - until the end of the course.

[25], [26],

Homeopathy

Some doctors successfully practice homeopathy as an alternative therapy for inflammatory suppuration in the ear in adults. The main means that are recommended to be used in such situations are:

• Aurum - prescribe for severe burning pains that spread to the entire area of the head and even around the neck.
• Barite carbonate - used in the defeat of auditory ossicles and a strong allocation of purulent mass, especially - in the chronic form of the disease.
• Calcium fluoride - used for ear pain, noise, crackling, inflammation of the parotid lymph nodes, with chronic otitis.
• Calcium iodate - is prescribed for lesions of the bone system, with calcification of the membrane.
• Causticum - used to eliminate thick purulent discharge, to get rid of the deafness and pulling soreness.
• Graphite - will help with pulsation in the ear, with glue-like discharge, with the effect of "echo".

As a rule, with ear inflammation adults use the 3rd or 6th decimal dilution, or the 3-6th centenary dilution. Dilute 2-3 grains in 100 ml of water and drink in small sips every half hour. As the state of health improves, they are taken in the morning and in the evening, until the state returns to normal.

Surgery

In situations where the use of medication for inflammation of the ear with the formation of pus did not bring the expected results, the doctor can prescribe an operation. The surgeon's assistance is also required if there is an increased risk of intracranial complications or the development of a septic condition. Indeed, if the cavity is not opened in time and the pathological discharge is not ensured, the complications will not take long to come.

What types of surgery can be used in purulent otitis in adults?

• Anthotomy - the operation of opening the cellular cave of the mastoid process, with further drainage and the introduction of antiseptics. This type of surgery is carried out only for emergency indications.
• Timpanotomy is the operation of opening the membrane to facilitate the removal of the pathologic discharge of their ear cavity. In the future, catheterization is possible for the administration of medications.

What kind of surgery to conduct, the doctor decides. Drainage after dissection is carried out until all the intoxication symptoms are eliminated.

Operation with purulent otitis

Tympanotomy - otherwise this operation is called paracentesis, refers to small surgical interventions. It is generally believed that this procedure is appropriate if the patient does not feel relief for three days after the initiation of drug therapy.

Intervention is performed under local anesthesia. Using a special needle tool, the doctor makes a cut in the membrane, to ensure the necrotic mass is withdrawn. It is not necessary to survive: this incision will drag on independently, as soon as the pus stops forming.

After surgery, healing is faster. In addition, as a postoperative treatment, the doctor appoints complex drugs - antibiotics, neuroprotectors, and also means for improving microcirculation in the hearing organs.