Anti-Biotics Necessary For Ear Infection

[Wrong Turn]

I have an outer ear infection.

I went to an ENT doctor, who cleaned my ear, prescribed drop and anti-inflammatories. I am getting my ear cleaned every day and a new cotton ball put into my ear with some form of medicine on it.

The anti-biotics he prescribed is pennicilen/amoxycillen which I'm allergic too, so I have not taken it. (I found out the brand of anti-biotic was pennicilin after getting home from the doctor's office.) I am also not taking the anti-inflammatories.

So my question is:

Since I am cleaning my ear at the doctors and keeping it clean and dry,

can I avoid taking anti-biotics for the outer ear infection?

Or, is taking anti-biotics, a must?

Thanks to anyone that can help.

[Tolley]

Tea Tree oil is supposed to work for these sort of infections.

[Wrong Turn]

Tea Tree oil is supposed to work for these sort of infections.

Thanks, Tolley.

So, are you saying anti-biotics are not necessary?

[FBN]

The current treatment is appropriate and antibiotics has a limited effect on the outer ear infections but if there are regional lymph gland enlargement, fever, redness and swelling of the ear (pinna), then it means the infection has spread beyond just the canal and antibiotics are necessary. If not, the local treatment is the most important (daily cleaning) and it will probably clear up without oral antibiotics.

[hhgz]

There are many types of antibiotics besides penicillin.

[Wrong Turn]

The current treatment is appropriate and antibiotics has a limited effect on the outer ear infections but if there are regional lymph gland enlargement, fever, redness and swelling of the ear (pinna), then it means the infection has spread beyond just the canal and antibiotics are necessary. If not, the local treatment is the most important (daily cleaning) and it will probably clear up without oral antibiotics.

Thanks for the help, FBN.

The swellen below my ear (on the top left side of my neck is gone, as well as the pain.) No fever, now swelling of the ear ever occurred.

I am getting the daily cleaning, for a total of 5 days, and today was day number 3.

I'll not pursue oral anti-biotics as I am improving.

Thanks for the information, as I needed to know.

[Wrong Turn]

There are many types of antibiotics besides penicillin.

Yes, that was my fault. In my pain and tiredness I forgot to mention I was allergic to pennicilin, and this was a new doctor's clinic I went to.

Thanks for the reply.

[wpcoe]

The current treatment is appropriate and antibiotics has a limited effect on the outer ear infections but if there are regional lymph gland enlargement, fever, redness and swelling of the ear (pinna), then it means the infection has spread beyond just the canal and antibiotics are necessary. If not, the local treatment is the most important (daily cleaning) and it will probably clear up without oral antibiotics.

I suffer frequent ear infections and keep them in check with a combination of vinegar flushes (2x daily to raise pH level) and Sofradex antibiotic/antiimflammatory drops 3x daily. However, this time the infection got out of control, and my ear canal is almost totally closed, so it's difficult to get anything in there, and is quite painful.

Today an ENT cleaned out some "debris" with a tiny tube vacuum and like the OP inserted a small strip of cotton which I saturate with Sofradex 3x daily, and I am return daily to change the cotton until the ear canal swelling goes down sufficiently to allow normal application of the Sofradex drops.

HOWEVER, in addition to the Sofradex topical antibiotic, she also prescribed TWO oral antibiotics: Dicloxacillin (500 mg cap 4x daily) AND Ciprobay (500mg tablet 2x daily). The glands at the sides of the throat just below the jaw are not swollen, but pretty much the side of my face is sore -- chewing is quite painful, and the pain has spread to behind my eye, though not intense pain there.

Does that seem like overkill on antibiotics? I know the tendency of Thai doctors to overprescribe meds, especially antibiotics, and wondering if I *need* to take *three* antibiotics for an ear infection?

[Sheryl]

The topical antibiotic will work only on the ear canal and fro m the severity of your symptoms, she suspects the infection may have extended into surrounding tissues, hence the addition of oral antibiotics.

She's covering her bets since at this point she does not know what organism is responsible nor what antibiotics it is sensitive to. . She should get a culture & sensitivity of the "debris" she removed, try & make sure she does and then adjusts the antibiotics accordingly.

[wpcoe]

She didn't mention about doing a culture of the debris, so it's probably already been disposed of.

Based on your feedback, I will start both courses of oral antibiotic. I was holding off until morning to see what advice I would get here. Once you start a course of antibiotics, you must finish the course to prevent intolerance of that antibiotic in the future, no?

Thanks, as always, Sheryl, for your valuable advice and information.

[Sheryl]

Yes, you should complete the full course.

And she should have done a culture. You might check your bill to see if it contains a lab charge, as that would indicate she did.

[Gers1873]

There are many types of antibiotics besides penicillin.

Alternative to penicillin

Erythromycin is an antibiotic. It is an active ingredient in many different prescription medications. Erythromycin comes in many different forms, such as tablets, capsules, injection, various skin products, and eye ointments. It is used to treat and/or prevent a variety of different infections.

Or try antifungals which can treat a bacterial or yeast infection.

[Sheryl]

Antifungals cannot treat bacterial infections. they treat only fungal infections, of which "yeast" is one.

The choice of antibiotic in a bacterial infection needs to be based on the specific bacteria (known by culture or suspected based on usual causative agents) involved and its pattern of antibiotic sensitivity. this is a more complex matter than people often assume. It is not as simple as bacterial infection = antibiotic = this or that drug.

Erythromycin is indeed often used for people allergic to penicillin, but only if their infection is due to an organisms sensitive to that family of antibiotics.

[wpcoe]

And she should have done a culture. You might check your bill to see if it contains a lab charge, as that would indicate she did.

No lab charge on the bill, just B3,000 of Drugs, Medical Equipment, Nursing Charge and Physican Evaluation. (B2253 was Drugs.)

I've only had one contact with this ENT doctor, and my initial impression isn't all that great. I saw her handling the cotton strip which was to be inserted into my ear canal with her bare hands (without washing or sanitizing them first), when I expected it would be handled with gloved hands and sterile equipment, and after carefully inserting the cotton strip into my ear canal, she accidentally snagged it with her "tweezers" (not sure what to call them) and it came totally out. I don't fault her for that, but I was surprised that she proceeded to re-insert the same piece, rather than start with a new piece. Just my uneducated opinions, but those actions did not particularly impress me.

[Sheryl]

There would be a separate lab charge if a culture had been sent, so I think we can assume she did nto send a culture. Should have, assuming there was anything by way of pus etc to send.

So it goes. If you do not improve, see a different doc (checking qualifications carefully befiore hand, selecting for biard certifiaction in ENT oreferrably in a western country). And insist on a culture.

[wpcoe]

Problem with Bangkok Hospital Hua Hin is that it's so new, and its web site is pretty sparse, they don't even list many of the doctors on their staff yet. e.g. My "primary care" physician who I've been consulting since July is nowhere to be found online, and is not even on the picture chart on the wall of the outpatient section of the hospital.

Also, the stand-in doctor (Dr Nut Niyomiudonwatana) who came in from Bangkok Hospital on the Hua Hin ENT's days off could not be found via a Google search. Granted his loooong last name could be problematic, but I scrolled through many ENT doctor lists on the Bangkok Hospital web site, and found nothing close to his name.