Otitis externa, commonly called "swimmer's ear," is an infection of the ear canal. It's not related to the more common otitis media (usually referred to as an "ear infection"). The causes of otitis externa, along with the treatment, are very different.
To become infected, the ear canal must have a scratch or other defect in the skin, and be exposed to bacteria that can cause otitis externa. When a child has swimmer's ear he has pain in the ear, decreased hearing, ear itching, foul smelling ear discharge, and swelling of the ear canal. Sometimes the swelling is so severe that the canal is totally closed.
The treatment is steroid drops to lessen the swelling and appropriate antibiotic drops. Rarely are oral antibiotics required. There are combination antibiotic-steroid drops available to treat this problem. Now there's a new combination product available to treat otitis externa.
Ciprofloxacin is an antibiotic used to treat many infections. It's been combined with the steroid hydrocortisone, resulting in a safe and highly effective drop used to treat otitis externa. This new combination (sold as Cipro HC Otic) was compared to the standard treatment, polymyxin B-neomycin-hydrocortisone drops. There were 1,286 patients in the study; half treated with Cipro, the other half with polymyxin.
The ciprofloxacin combination was much more effective in eradicating the bacteria than the polymyxin product. If not treated properly, otitis externa may, in rare circumstances, develop into chronic inflammation or infection of other parts of the body.
The Medical Herald, 8/98, p. 28.
Harry Pellman, M.D.
Dr. Pellman's column appears monthly in Pediatrics for Parents. He's a Board Certified Pediatrician practicing in Huntington Beach, California, a Clinical Professor of Pediatrics at the University of California, and a Medical Associate of the La Leche League International. He welcomes your comments.
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