Antibiotics for the treatment of otitis media in adults are not always used. In most cases, with this pathology, recovery is possible without the use of antibacterial agents. In addition, in many cases, the course of the disease is due to a viral infection for which antibacterial agents are ineffective.
However, experts who believe that antibiotics are necessary for otitis media proceed from the fact that about 30,000 people die every year in the world from complications caused by this pathology. In addition to hearing loss or the development of deafness, complications of otitis media can be such serious diseases leading to the development of death as mastoiditis, meningitis, sepsis, brain abscess. In this case, you cannot do without the use of antibiotic therapy.
Indications for antibiotic therapy
In modern otolaryngology, antibiotics for otitis media in adults can be used in the following cases:
- the lack of effect from the treatment carried out for two days with anti-inflammatory, antiseptic and other means;
- severe course of the disease, accompanied by pronounced symptoms of intoxication, hyperthermia;
- the presence of concomitant severe pathology complicating the course of the disease (endocrine diseases, severe kidney and liver damage, tuberculosis);
- existing immunodeficiency states (oncopathology, blood diseases, HIV).
The choice of the remedy is carried out in accordance with the clinical manifestations of the disease, its course. Treatment approaches can differ markedly, also based on the localization of the process.
Before using external agents, it is imperative to consult a specialist.
What antibiotics to take for otitis media? It all depends on the type of otitis media and the causative agent of the infection. The drops, which are effective and safe for otitis externa, can cause hearing loss if used for suppurative inflammation accompanied by perforation of the tympanic membrane.
Principles of prescribing antibiotics
Antibiotics for otitis media exist in various dosage forms, tablets, injectable solutions, drops. Giving preference to one or another drug, proceed from the fact that taking antibiotics of systemic action is accompanied by pronounced side effects, such as decreased immunity, the development of dysbiosis. Local preparations, including ear drops, are devoid of these disadvantages. They are safer because they are hardly absorbed into the bloodstream.
The purposefulness of the action also testifies in favor of their use, as a result of which the effect of the application develops quickly. The popularity of ear drops is also promoted by the convenient form of release, which allows the patient to use them independently, as opposed to injectables. Therefore, in all cases, where possible, preference should be given to topical antibiotics, that is, agents in the form of drops.
When using antibiotics for otitis media, it must be remembered that some of them have a strong ototoxic effect, acting on the receptor apparatus of the hearing organ.
First of all, this concerns gentamicin, kanamycin, widely used drugs in the treatment of various pathologies. It is also unacceptable to use antibiotics such as benzylpenicillin, lincomycin, which have minimal activity against otitis media. Irrational prescription of an antibiotic can lead to the development of a more resistant pathogen, which will significantly complicate treatment. The antibiotic ampicillin cannot be used for ear inflammation, since it is significantly inferior in its activity to its analogue, amoxicillin.
Antibiotic therapy for otitis externa
The most common cause of ear inflammation is staphylococcus, Pseudomonas aeruginosa, or a fungal pathogen, so antibacterial or antifungal drugs may be needed to treat this form of otitis media. Otitis externa is characterized by a mild course. In the absence of concomitant pathology, which could complicate the course of the disease, local drugs, drops with antifungal, antibacterial action are sufficient. Combined means, consisting of substances different in their action, can also be used.
The most popular antibiotic for the treatment of otitis media, Candibiotic, which is actively used in this localization of the inflammatory process, is a combined agent, which also includes the antifungal component clotrimazole, which significantly expands the scope of the drug. The appointment of Sofradex is due not only to incoming
it contains an antibiotic, but also the presence of a corticosteroid, which is a powerful anti-inflammatory agent.
Antibiotic treatment for otitis media in adults should be at least 7 days.
It is not recommended to interrupt treatment at an earlier date, as this will contribute to the development of more resistant strains of pathogens.
Features of the use of drops
The course of acute otitis media consists of several stages:
- catarrhal;
- purulent;
- restorative.
Drops from otitis media with an antibiotic can not be used in all stages of the process. The catarrhal stage, in addition to signs of inflammation, is characterized by an integral tympanic membrane.
The use of antibiotics in the form of ear drops for an intact tympanic membrane is ineffective, since they do not reach the middle ear.
With this flow, drops are shown that have an antiseptic, analgesic, anti-inflammatory effect, as well as thermal procedures. Antibiotic treatment of ear inflammation in its catarrhal stage involves the use of tablet preparations.
The most reliable method for choosing the required antibiotic is to determine the sensitivity of the pathogen to this drug.
However, bacteriological research is carried out over several days. It makes no sense to wait for the results for so long. Antibiotics for otitis media in adults are prescribed based on the activity of the drugs against the most common pathogens.
What antibiotics to drink with otitis media is due to what pathogens are most typical for this disease. Antibiotic therapy for otitis media includes the use of amoxicillin and its derivatives. In the event that the use of amoxicillin derivatives was not very effective, augmentin or amoxiclav is prescribed, which are a combination of amoxicillin with clavulanic acid, which significantly increases the effectiveness of the drugs. An agent from the group of cephalosporins (Zinnat, Supero, Ketocef) may also be prescribed. The reserve drug is antibiotics from the fluoroquinolone group. Drinking the antibiotic levofloxacin for otitis media is recommended for prolonged acute otitis media or the existing risk of complications.
Local treatment
Drops in the ears with an antibiotic for otitis media are varied. The most popular are the following:
- Otofa;
- Tsipromed;
- Norfloxacin, or its analogue Normax;
- Candibiotic;
- Fugentin.
The active ingredient in Otofa drops is rifamycin. Consequently, the use of the drug may be limited by intolerance to this active substance.Drops based on norfloxacin have a wide spectrum of antimicrobial action, which is the reason to prescribe them not only in the treatment of purulent otitis media, but external and chronic. Drops based on ciprofloxacin (Cipromed, Ciprofarm) can also be widely used. However, it should be noted the possibility of developing allergic reactions as a result of the use of the drug, up to Quincke's edema.
The use of any combined agent for otitis media should be under the direct supervision of an otolaryngologist. Many drugs include non-steroidal anti-inflammatory drugs, which is a contraindication for use with a damaged eardrum.
It is necessary to use alcohol-containing drops with caution, since this component has an irritating effect on the mucous membrane of the tympanic membrane, which aggravates the pain.
Treatment of acute otitis media of the middle ear is carried out based on the clinical characteristics of the process, its severity and the reasons that led to the development of this pathology. Common causes of inflammation of this localization are diseases of the nasopharynx, accompanied by rhinitis, swelling of the nasal mucosa, such as ARVI, sinusitis. In this case, the pathogen penetrates from the nasopharynx into the tympanic cavity through the Eustachian tube. To prevent the effects of this unfavorable factor, it is necessary to carry out measures aimed at preventing the throwing of exudate from the nasal cavity into the middle ear. The use of vasoconstrictor nasal drops, galazolin, sanorin, naphthyzin, helps to reduce the edema of the auditory tube and improve its patency.
Antibiotic therapy for otitis media should be carried out within the time frame established by the ENT doctor, at least 7 days. If the clinical manifestations of the disease have decreased by the second or third day, this should not be a reason to discontinue the drug. Otherwise, the disease can become chronic. In addition, the frequency of admission recommended in the instructions for the drug must be observed.
The chronic course of otitis media is a surgical pathology.
Medical treatment of this form of otitis media is possible only with an exacerbation of the process or preparation for surgery. The absence of an acute stage indicates the possibility of only surgical treatment. Antibiotics for otitis media in adults in this case are used taking into account the results of a bacteriological study of microflora and sowing it for sensitivity.
To achieve the maximum effect, quite often, in any course of the process, they resort to prescribing drugs with different points of application. In this regard, local and systemic antibiotics are used together. For example, for treatment, Otofa drops can be used in combination with Amoxiclav inside.
What antibiotics are preferable for otitis media in adults, the otolaryngologist should decide. Diagnosis of diseases is quite simple for a specialist who has the skills and special tools to assess the condition of the tympanic membrane. Those drugs that are effective in one localization of the process may be useless or even dangerous in other cases. In addition, antibiotic treatment for otitis media in some cases is generally unjustified.
