Antibiotic for otitis media

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Review of popular antibiotics for otitis media

Antibacterial agents are an important component of the treatment of ear infections. At the same time, it is unacceptable that the selection of a drug is carried out empirically (experimentally).

Table of contents:

How, with all the diversity presented on the pharmacological market, to choose the appropriate antibiotics for otitis media, and what you should know before taking them - read the full review of products related to modern antimicrobial drugs.

What antibiotics are used to treat otitis media

Three large groups of antibacterial drugs are used to treat otitis media.

Penicillins

Penicillins are the best known antibiotics for treating ear infections. It is known that the first samples of a product with antimicrobial activity were isolated by A. Fleming from green mold in 1940.

Since then, penicillin and its derivatives have saved many lives. Today, the natural drug is practically not used; doctors prefer its semi-synthetic analogues, presented in the table below.

The antibiotic is unstable to the action of beta-lactamases - protective enzymes of bacteria. As a result, there are increasingly no results from drug therapy.

There is also no resistance to bacterial beta-lactamases.

The bioavailability of the drugs is increased to 97% (taking the tablet is equivalent to an intravenous injection).

The drugs in this group are the most popular antibiotics for otitis media in children.

Amoxicillin + clavulonic acid

The drugs have become resistant to bacterial protective enzymes

All penicillins have a broad spectrum of action and are active against both gram-positive and gram-negative otitis media. The mechanism of action of the drugs is based on the destruction of the bacterial cell wall.

Penicillins are first-line drugs for the treatment of uncomplicated otitis media, as well as ear infections in children.

The advantages of penicillins include:

  • Safety, possibility of use in children, including newborns, as well as pregnant and lactating women;
  • Many forms of release (tablets and capsules, suspension, solution for intramuscular and intravenous administration), ease of use for adults and children;
  • No toxic effect or negative impact on internal organs;
  • Affordable price.

The disadvantages of drugs from the penicillin group in the treatment of external and otitis media are:

  • Increasingly common cases of resistance (resistance) of microbial cells to antibiotics;
  • A high percentage of patients with individual intolerance or allergic reactions to penicillins;
  • The need to strictly adhere to the schedule and take medications 3-4 times a day.

Cephalosporins

For the first time, cephalosporin antibiotics were isolated from a culture of Cephalosporinum fungi. Their mechanism of action is similar to the antibacterial activity of penicillins. Doctors prefer to treat ear inflammation with the help of the following class representatives:

III generation injection antibiotic. Like most cephalosporins, it has a wide spectrum of action, is resistant to the action of protective bacterial enzymes, and is well tolerated by patients. Ceftriaxone can be prescribed to children over 1 month of age, pregnant and lactating women only after examination by a doctor and risk assessment.

Another semi-synthetic representative of third generation cephalosporins. The active substance is cefixime. Available in the form of capsules (200, 400 mg) and powder for self-preparation of a suspension. Suprax is used with caution in chronic liver failure.

Zinnat (active substance – cefuroxime).

Another bright representative of the class of antibacterial agents for the treatment of otitis media. Available in powder form for preparing a suspension. Zinnat is often prescribed for ear infections in children.

  • Higher efficiency compared to penicillin antibiotics;
  • Almost 100% resistance to beta-lactamases;
  • Can be used in children after consulting a doctor.
  • Limited use of drugs in patients with liver and kidney failure;
  • Cases of allergies (including cross allergies with penicillins);
  • With long-term use: dysbacteriosis, intestinal microflora disorders.

Macrolides

Macrolides were first synthesized during the study of radiant fungi. The pharmacological effect of the drugs is bacteriostatic, which consists in suppressing the key moments of protein synthesis by the microbial cell and disrupting the processes of replication (reproduction) of the virus.

Today, this group of drugs is considered one of the most effective for the treatment of otitis media in adults and children. They are resorted to in cases of intolerance or ineffectiveness of therapy with penicillins and cephalosporins. Popular macrolides include:

Sumamed (active ingredient – ​​Azithromycin).

Broad-spectrum antimicrobial drug. Available in the form of capsules, tablets, powder for suspension. There is also an injectable form of the medicine. In addition to the widely used Azithromycin-based Sumamed, several other products with a similar effect are produced: Azitro, Azitrox, Ecomed.

Klacid (active ingredient – ​​Clarithromycin).

The medicine is available only in the form of tablets with prolonged action. Klacid is contraindicated in children under 18 years of age.

  • High efficiency;
  • The products allow you to treat ear infections caused not only by microbes, but also by intracellular parasites (mycoplasma, legionella);
  • Take only 1 time per day;
  • The course of treatment does not exceed 3 days, during which a significant improvement in the patient’s condition usually occurs;
  • Side effects are rare.
  • Effect on the gastrointestinal tract, the possibility of developing dysbacteriosis;
  • High price.

Representatives of other groups of drugs are used less frequently for the treatment of otitis media in adults:

Tsiprolet (active ingredient – ​​ciprofloccin).

A highly sensitive antibiotic from the fluoroquinolone group. Used for the treatment of mixed otitis caused by gram-positive and gram-negative flora, as well as anaerobic bacteria. Tsiprolet is prohibited for use by children and adolescents under 18 years of age, as well as pregnant and lactating women. Similar drugs based on ciprofloxacin are Tsifran, Tsipromed.

Lincomycin is an antibiotic from the lincosamide group.

The drug has a pronounced antibacterial effect due to its ability to suppress viral replication processes. Lincomycin is a reserve drug and is prescribed only if it is impossible to use the medications listed above.

How to choose an antibiotic for the treatment of otitis media

Antibiotics for otitis should be prescribed by a doctor after a comprehensive and comprehensive examination. To reliably determine the causative agent of the infection, a bacteriological examination of an ear smear is carried out.

Normally, the microflora of the external auditory canal is quite sparse and is represented by several types of corynebacteria, sapophytic microbes, and fungi. The middle and inner ear are usually kept sterile.

For infections, a smear from the ear canal is examined as follows:

  • Collection of biological material (direct smear);
  • Sowing ear discharge onto a nutrient medium, culturing for 3-5 days;
  • Inspection and assessment of grown colonies;
  • Transfer to glass slides, Gram staining, microscopic examination;
  • Antibiotic sensitivity tests (inoculation of colonies on a nutrient medium pre-treated with antibiotic solutions). If the bacterium is sensitive to the drug, its growth on the nutrient medium slows down or completely disappears.

Thus, the bacteriological and bacteriostatic method for studying ear diseases makes it possible to determine the causative agent of infection with up to 99% accuracy. Remember to visit a doctor before treating the disease with antibiotics and anti-inflammatory drops.

Drops for otitis with antibiotic

Local agents (sprays, drops) also come to the rescue with otitis media:

Spray, solution (drops) for external use

Polydexa contains two antimicrobial components, due to which its activity expands.

Drops are indicated for the treatment of external and otitis media.

Spray for external use in bottles with a sprayer, solution (drops)

Isofra has a bactericidal and antimicrobial effect. The drug is based on the substance framecitin (local antibiotic).

Aerosol for external use

Bioparox has pronounced anti-inflammatory, antiseptic and antimicrobial properties. Can be used to treat external and otitis media in adults and children.

Rules for the use of antibiotics for otitis media

Doctors around the world warn against the uncontrolled use of antibiotics: every violation of the rules for taking the drug, every incomplete course of treatment is fraught with the development of resistance in bacteria to antibacterial agents.

This is dangerous because in the future, perhaps, humanity will no longer be able to treat microbial diseases, and a banal sore throat or otitis may become a threat to life.

Follow the rules for using antibiotics:

  • Do not stop the course of treatment, even if the temperature has subsided, the ear pain has decreased, and you feel well;
  • Observe the intervals between taking pills or injections. It is desirable that they be exactly 8 (with three doses) or 12 (with two doses) hours;
  • Take the tablet only with clean boiled water, and not with juice, tea, coffee, milk, etc.;
  • The simultaneous use of antibiotics and alcohol is strictly prohibited - such a mixture destroys liver cells and negatively affects the body as a whole;
  • During the course of taking antibacterial drugs, limit your exposure to direct sunlight and do not visit the solarium: taking medications can cause photosensitivity - an atypical reaction to ultraviolet rays.

And most importantly, do not take antibiotics without a doctor’s prescription. Self-medicating ear infections can be dangerous.

The best antibiotics for the treatment of otitis in adults: getting rid of ear diseases

Otitis media, or inflammation of the hearing organs, is quite common among people of all ages. The disease requires the most serious approach, since in the absence of adequate therapy it can lead to irreversible hearing loss and other serious consequences. Properly selected antibiotics for otitis media in adults are guaranteed to shorten the duration of treatment and avoid unpleasant complications.

Causes of development and types of disease

The causes of otitis media development primarily include harmful bacterial flora, the presence of viruses or fungi in the body. Also among the causative agents of the disease are Hemophilus influenzae, pneumo, strepto, and staphylococci.

There are different types of the disease, classified depending on the location. Otitis may be:

  • external;
  • moderate (catarrhal, purulent, influenza, etc.);
  • internal, so-called labyrinthitis.

Otitis that occurs within 3 weeks is considered acute, lasting up to 3 months is considered subacute, and beyond this period is considered chronic.

When does it become necessary to take antibiotics?

Antibiotic therapy is recommended in the following cases:

  • with the development of inflammation and the absence of results from symptomatic treatment;
  • with spontaneous damage to the ear membrane with subsequent release of exudate (specific fluid produced during the course of the disease);
  • with severe pain in the ears and decreased hearing acuity;
  • to prevent possible complications in patients with weakened protective immune function.

Many people are interested in whether otitis media can be cured with antibiotics alone. To completely get rid of the infection, they additionally resort to the use of analgesics and anti-inflammatory drugs, heating and rinsing with antiseptics.

After the appearance of purulent discharge, a sample of the microflora is taken to determine the level of its sensitivity to specific drugs. The decision about whether antibiotics are needed for otitis is made by the doctor in each individual case, after interpreting the results of laboratory tests.

In severe cases of the disease, parallel use of several types of drugs used in various forms is recommended.

Types of antibiotics used and basic rules of treatment

Experts determine which antibiotics a patient should take based on many indicators. Penicillins are at the top of this list, as they are most often used for ear diseases.

There is a standard regimen for using antibiotics. In most cases, they are taken from 7 to 10 days. The main, “shock” dose is prescribed only in the first 3 days. If there is no relief, the form of administration of the drug is changed.

During treatment, constant monitoring for side effects is necessary. If it occurs, the patient must immediately notify the attending physician. If the presence of undesirable effects is insignificant, there is no need to change treatment, however, particularly complex cases may require dose adjustment or complete withdrawal of the drug.

Monitoring the condition of the liver and kidneys is no less important. In case of changes in laboratory test results, treatment tactics are also changed.

Antibiotics tend to “conflict” with other medications. For this reason, you need to carefully monitor which drugs they are not combined with.

Antibiotic therapy is used to a limited extent in old age, and is completely contraindicated in pregnant and lactating women. In these cases, symptomatic treatment of otitis is carried out, without the use of antibiotics.

Independent choice of such drugs for otitis is unacceptable, since the lack of control over treatment by a specialist is fraught with the most negative consequences. Deciding on your own which antibiotics to take for otitis media is not safe. Treatment without taking into account the results of the antibiogram, in incorrect doses and incomplete courses leads to severe complications, the development of a chronic form of the disease and frequent relapses.

Antibiotics for external otitis

When external forms of otitis are detected, antibiotics are prescribed when the disease passes into an acute or chronic stage, and when pus appears in the area of ​​localization of inflammation.

Antibiotic therapy is also indicated for pain in the hearing organs and weakening of their sensitivity.

To cure the external form of otitis, use medications in the form of capsules or tablets based on:

Popular antibiotics for external otitis are Ampicillin and Oxacillin, often used together. Both agents are capable of suppressing the synthesis of bacterial cell walls. They can be administered intramuscularly or intravenously, or prescribed orally.

Azithromycin is the leader in frequency of prescription for otitis media. A wide variety of microorganisms are sensitive to it. The drug affects them, suppressing protein synthesis and depriving them of the ability to further live. Amoxicillin is considered a 4-hydroxyl analogue of ampicillin. Active against aerobic gram-positive bacteria, but ineffective against microorganisms that produce penicillinase.

Cefazolin is a first generation antibiotic with a bactericidal effect. It is active against both gram-positive and gram-negative microorganisms.

Along with the above-mentioned drugs, they often use drops and ointments, and give injections with an antibiotic. If a mixed infection is detected (bacteria in combination with Candida fungi), the desired effect is achieved by using Nystatin, Candibiotic and the local drug Oxycort. For inflammation of the skin and boils in the area of ​​the external auditory canal, Gramicidin drops are used in the form of a 2% alcohol solution. Its closest analogue is Sofradex.

The ear antibiotic Normax with a high content of norfloxacin is popular. The drug has a considerable spectrum of action, so it is also prescribed for purulent otitis media.

Antibiotics for otitis media

Otitis media of the middle ear is mainly treated with drugs available in the form of drops:

Anauran in the form of drops with an antibiotic has anti-inflammatory and antibacterial effects. Helps cure acute and chronic forms of otitis media.

Otofa is known as a powerful drug that is effective in cases of ruptured eardrum. Its distinctive feature is its minimal analgesic effect.

Tsipromed, which is drops for otitis media, is prescribed to patients no younger than 15 years of age. The drug contains ciprofloxacin, which is a widely used antibiotic.

Fugentin is highly effective in the treatment of purulent otitis, but is contraindicated in cases of perforated eardrum. Ceftriaxone is on the list of antibiotics that have a wide spectrum of action and counteract the process of synthesis of bacterial cell walls. The drug is characterized by high activity against most known bacteria. For medicinal purposes it is used in the form of intramuscular injections.

Various antibiotics are widely used for purulent otitis media. In this case, therapy is carried out using Amoxiclav, Clarithromycin, Erythromycin, Flemoxin Solutab. If the disease is protracted, it becomes necessary to prescribe non-steroidal anti-inflammatory drugs - Diclofenac or Olfen. The chronic form of the disease often requires the use of Ciprofloxacin, a first generation antibiotic widely used in Europe.

Antibiotics in the treatment of internal otitis

By internal otitis (labyrinthitis) we mean an inflammatory process that develops in the inner ear. Symptoms and treatment of this form of the disease most often involve hospitalization and hospital stay. Tactics to combat the disease are developed by specialists depending on the causes of its occurrence and the characteristics of the clinical picture.

The basis of drug treatment for labyrinthitis is the use of drugs belonging to various groups. Antibiotics are prescribed after an antibiogram. At the same time, taking medications to relieve inflammation and normalize metabolic processes occurring in the inner ear and brain is indicated.

Therapy for internal otitis is carried out using:

Amoxicillin and Piperacillin, used for various types of otitis, have a destructive effect on the cell walls of bacteria. The result is a reduction in the ability of various types of microorganisms to reproduce, as well as suppression of the production of bacterial enzymes. For labyrinthitis, both drugs are used for intravenous drips.

Oxacillin in tablet form tends to exhibit high activity against streptococci and staphylococci. With its help, you can treat otitis media intramuscularly and intravenously. Erythromycin, taken mainly orally, tends to block the proliferation of bacteria by disrupting the formation of protein bonds in them. Clarithromycin has a destructive effect on the protein synthesis of microorganisms. The drug must be taken orally.

Sumamed is classified as a broad-spectrum antibiotic from the macrolide-azalide group. The main component of the drug is azithromycin, a compound of semi-synthetic origin. Thanks to this feature, it is able to be absorbed as quickly as possible, absorbed into the blood, and penetrate into the cells of affected tissues and foci of infection.

In case of an aggravated chronic form of labyrinthitis and sudden symptoms of dysfunction of the inner ear (labyrinthine attack), along with antibiotics, the use of vestibulolytics (drugs that reduce the intensity of dizziness, eliminate nausea and bradycardia, and normalize coordination of movements) is indicated.

Prognosis and recovery after antibiotic therapy

Timely initiation of an adequate course of treatment for otitis with antibiotics guarantees a positive prognosis with 100% cure. When taking all types of medications, you must strictly follow the instructions, do not use them for longer than the recommended period and do not increase the dosage prescribed by your doctor. If complications occur, it is important to immediately contact a qualified specialist.

Treatment with antibiotics does not always take place without leaving a trace. Long-term use of such drugs often provokes a weakening of the immune system and an imbalance of intestinal microflora. After intensive antibiotic therapy, it is recommended to carry out a full recovery course with prebiotics, immunostimulants and vitamin complexes.

Source: http://lor-expert.ru/ears/otitis/antibiotiki-pri-otite-u-vzroslyh.html

The choice of antibiotics in the treatment of otitis media in adults

Inflammatory diseases of the middle ear are an important clinical and social problem. This is due to their prevalence among all age categories, untimely contact with an ENT doctor and frequent attempts at self-medication, which significantly increase the risk of intracranial complications and irreversible hearing loss of varying severity.

Causes of inflammation

The frequency of this pathology, the severity of the course and the variety of development mechanisms are determined by anatomical and physiological characteristics.

In adults, the auditory tube has a relatively larger lumen than in children, and is located above the nose at an angle of 45 degrees relative to the ear. It opens into the nasopharynx at the level of the inferior turbinate.

When the mouth is opened wide, swallowing and yawning, the mouth of the tube opens, which is a predisposing factor for the spread of infection from the nasal cavity or throat.

Hypertrophy of the tubal and pharyngeal tonsils also complicates normal ventilation of the tympanic cavity and can cause a serious inflammatory process.

For otitis media, risk factors also include: general sensitization of the body, chronic tonsillitis, sinusitis and rhinitis, and in children - adenoid vegetations.

The inflammatory process is usually associated with bacterial flora, less often the cause is fungi or viruses.

Therefore, antibiotics for otitis in adults and children form the basis of treatment. The initial course is carried out empirically, with broad-spectrum antimicrobial agents, covering the entire range of suspected pathogens (pneumo, strepto and staphylococci, Haemophilus influenzae).

Further adjustment, if it is necessary to prolong therapy, is based on the results of flora cultures for sensitivity. The duration of treatment depends on the severity of the inflammatory process, the state of the immune system, the presence of complications and concomitant pathologies.

Classification

  1. By duration:
  • acute otitis media - up to three weeks;
  • subacute - from three weeks to three months;
  • chronic - over three months.
  1. By type of inflammatory process:
  • exudative;
  • purulent.
  1. By localization of inflammation:
  • otitis externa;
  • Otitis media

You can also join:

  • myringitis (the eardrum is affected);
  • mastoiditis (inflammation of the mastoid process);
  • labyrinthitis (damage to the inner ear is added).

Major complications

  • intratemporal (rupture of the eardrum, sensorineural hearing loss - type of damage to the sound-conducting apparatus, tympanosclerosis, facial nerve paralysis);
  • intracranial (meningitis, epidural abscess, subdural empyema, otogenic encephalitis, brain abscess, lateral sinus thrombosis, otogenic cerebral hydrocele).

As a rule, the inflammatory process affects the tympanic cavity, the auditory tube and the mastoid process. Damage to structures can be combined, therefore, when making a diagnosis, the predominant localization of the pathology in one or another department is taken into account.

Let us consider methods of treating the disease depending on its established form.

Antibacterial therapy for exudative otitis media

The disease manifests itself as a persistent serous inflammatory process that affects the mucous membrane of the auditory tube and the eardrum.

Antibiotics for ear pain in an adult, prescribed in the early stages of inflammation (before perforation appears), help prevent further progression of the pathological process and avoid irreversible hearing loss.

Four stages of the disease

  1. Catarrhal stage (eustachitis). Clinically, it manifests itself as mild tinnitus and mild hearing loss.
  2. During the secretory phase, mucus accumulates in the tympanic cavity. Patients complain of a feeling of fullness and pressure in the ear, a sensation of iridescent fluid in the ears when tilting and turning the head.
  3. In the mucosal stage, the secretion becomes viscous and thick. Symptoms of hearing loss are evident. When the membrane is perforated, sticky, sticky contents are released from the ear, trailing a cotton swab.
  4. In the fibrotic stage, a pronounced irreversible hearing loss is observed, and adhesive otitis media is formed.

Treatment of otitis media with antibiotics in adults, accompanied by exudative inflammation

Therapy begins with restoring patency and normal functioning of the pipe. They use the Politzer ear blowing method or using a catheter. The eardrum is massaged according to Siegl.

Blowing the ear canal using the Politzer method

During the procedure, hormonal drugs (hydrocortisone), antibiotics, and enzyme agents (trypsin, chymotrypsin) are administered through a catheter. Electrophoresis with lidase or proteolytic enzymes is effective.

General strengthening measures are indicated: vitamin therapy, the use of immunocorrectors (polyoxidonium).

Antibiotics for ear pain in adults are used systemically and locally.

  • Penicillins with an extended spectrum of action (Ampicillin and Amoxicillin) and inhibitor-protected penicillins (Amoxicillin/clavulanate, Ampicillin/sulbactam) are considered the drugs of choice for systemic administration.

Amoxicillin for otitis in adults

Amoxicillin is taken 500 mg every 8 hours. If the inflammatory process is severe, 1 g three times a day.

Treatment of pregnant women is carried out strictly under the supervision of a doctor.

Amoxiclav

Amoxiclav is used in a dosage of 375 to 625 mg every eight hours, or 1 g twice a day (preferably taken with meals).

For severe forms of the disease, amoxiclav for otitis in adults is used by parenteral administration at the rate of 1.2-2.4 g three times a day.

Antibiotics for external otitis

This term refers to an inflammatory lesion of the outer part of the ear canal. The disease is usually preceded by injury or water getting into the ear.

The main symptoms are: sharp ear pain and headache, itching and burning of the skin, an unpleasant purulent odor, and the presence of pathological discharge.

As the infectious process progresses, complete closure of the ear canal is possible with further spread of inflammation inside.

Diagnosis is based on clinical examination data, complaints and test results.

The blood shows signs of bacterial inflammation (most often): accelerated erythrocyte sedimentation rate, leukocytosis, neutrophilia with a shift to the left. If an allergic component is present, eosinophilia is diagnosed (usually in the chronic form).

Basic principles of therapy

Treatment includes hygienic care of the ear canal. The introduction of antibiotics into the ear for otitis media is combined with steroid drops. In case of a pronounced pathological process, with a tendency to deepen inflammation and involve adjacent anatomical structures, systemic antibacterial therapy is indicated.

  • Amoxiclav for otitis media is prescribed in standard dosages.
  • If flora is resistant to beta-lactams or the presence of Pseudomonas aeruginosa, fluoroquinolones (Ciprofloxacin, Norfloxacin) are prescribed.

Antibiotics for acute purulent otitis media

The inflammatory-infectious process covers the mucous membrane of the tympanic cavity and affects the anatomical structures of the middle ear. Antibiotics for the ears should be prescribed from the first hours of acute inflammation.

Let's consider 3 stages of the disease.

1. Imperforate

Accompanied by severe pain, general intoxication, and cognitive hearing loss. Pain in the ear is sharp, intense, radiating to the temporal region, steadily progressing. This is due to the accumulation of pathological exudate in the tympanic cavity and irritation of the receptors of the glossopharyngeal and trigeminal nerve. The general condition of the patient is disturbed, and the temperature may rise to several degrees.

  • antimicrobial therapy (penicillins, second generation cephalosporins, macrolides);
  • antihistamines (Loratadine, Erius, Diazolin)
  • decongestants (use derivatives of oxymetazoline and xylometazoline),
  • local anti-inflammatory therapy in the nose (Bioparox, IRS - 19) and ear (Otinum, Otipax, boric, furacillin alcohol)

Azithromycin for otitis media in the non-perforative stage

Macrolide. Its use is recommended if you are allergic to beta-lactam drugs or have contraindications to their use. Used for mild diseases.

Used in a daily dose of 500 mg for three to five days. Recommended use one hour before meals.

Surgery

Paracentesis of the tympanic membrane is prescribed according to the following indications:

  • the disease lasts more than three days;
  • general intoxication is expressed (meningismus, convulsive syndrome, high fever, severe pain);
  • bulging of the eardrum, smoothness of identification points during otoscopy.

Paracentesis is the puncture of the eardrum, followed by suction of pathological fluid through a needle from the middle ear cavity.

Myringotomy is usually performed after paracentesis. The procedure includes dissection of the membrane, removing pathological secretion products from the cavity. The cavity is washed with antibiotics.

2. Perforated

A rupture of the eardrum is accompanied by otorrhea, a decrease or even disappearance of pain, an improvement in well-being, and persistent hearing loss. Suppuration may persist for up to five days.

Antimicrobial therapy is prescribed according to indications.

Drops for otitis in adults with antibiotics are effective in the perforated stage

Water-based antibacterial drops are instilled into the ears after dry toileting the external auditory canal:

  • Anauran.
  • Otofa.
  • Polydexa.
  • Effective antibiotics for purulent otitis for adults when sowing Pseudomonas aeruginosa (Normax, Tsipromed).

Combined aerosol preparations of oxytetracycline and hormonal substances:

Local agents with anti-inflammatory action, in the nasal passages:

3. Reparative

It is characterized by scarring of the damaged part of the eardrum and the complete disappearance of otorrhea and pain. The patient's well-being returns to normal, and hearing gradually returns.

Basic antibiotics for otitis media

Often, antibiotics for otitis media in adults and children are taken without taking into account the data of the antibiogram, in an insufficient single and daily dose, or in too short a course, which leads to the transition of the process to the chronic stage, relapses or the development of severe complications.

Answer to the question: what antibiotics should I take for otitis media in adults? — is based on the principles of rationality and validity of antimicrobial therapy. Drugs for initial empirical treatment are selected taking into account the main pathogens. Preference is given to semi-synthetic broad-spectrum penicillins. Amoxiclav for otitis media is the drug of choice.

Ototoxic antibiotics for otitis media are completely excluded.

In the presence of allergic reactions to beta-lactam drugs, certain macrolides are prescribed (Sumamed, Roxithromycin).

The course of treatment is days, one drug is recommended to be used for 7-10 days. If it is necessary to extend therapy, a mandatory change of drug is carried out.

Ciprofloxacin is used only for external otitis, as well as in cases where the inflammation is caused by Pseudomonas aeruginosa.

Additional methods of treating otitis media

Complex treatment includes the administration of gammaglobulin, ribonuclease, and leukocyte interferon (intranasal).

Medicinal nasal electrophoresis with drugs is effective.

Anti-inflammatory therapy, sanitation of the upper respiratory tract, desensitizing and restorative therapy are carried out.

Anthrodrainage and anthrotomy, with the introduction of drugs into the ear cavity, are carried out in the absence of positive dynamics from the therapy used.

Infectious disease doctor A. L. Chernenko

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Antibiotics for otitis media

Otitis is an acute or chronic inflammatory process in various ear zones (external, middle or internal). Antibiotics for otitis media 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's consider the advisability of antibiotic therapy for inflammatory ear diseases.

Are antibiotics needed for otitis media?

Antibiotic therapy is very important in the development of inflammatory processes. However, many experts are of the opinion that until 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 resolves within 5 days. Antimicrobial therapy is used in cases where symptomatic treatment of catarrhal otitis does not bring relief to the patient: ear pain does not go away, hearing acuity worsens, and there are signs of general intoxication of the body.

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

Prevention of complications, especially in patients with low immune defenses, may also be an indication for antibiotic therapy.

What antibiotics should I take for otitis media?

The most popular drug, amoxicillin, 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 in patients with impaired liver function, during pregnancy and breastfeeding.

The 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 for the microflora of the discharge.

If it is impossible to test 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 media;
  • amoxicillin 3-3.5 grams per day;
  • augmentin 375 mg 3 times a day;
  • cefuroxime intramuscular injection;
  • ceftriaxone once a day;
  • ampicillin intramuscular injection.

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

Antibiotics for otitis media in children

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

If you detect signs of otitis in a child, you should 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 its infancy.

When the inflammatory process is mild in older children, they usually manage by eliminating the clinical manifestations of the disease, using analgesics, ear drops, compresses, ointments, and lotions. But if there is a characteristic picture of general intoxication of the body, there is an elevated temperature, persistent headaches - you cannot do without antibiotics. In such cases, the sick child must be hospitalized in a hospital, where the doctor decides on the further use of drugs. Usually, preference is given to the well-known and effective antibiotic amoxicillin. However, if the child’s well-being has not improved within two days from the moment of administration, another drug is prescribed, for example, from the cephalosporin series.

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

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 rinsing with antiseptic agents.

The type of antibiotic prescribed is determined depending on the infection present in the ear. In severe cases, simultaneous use of several types of antibiotics is possible, for example, orally and in the form of intramuscular injections.

In acute 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.

Antibiotics for acute otitis media

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

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

For the treatment of acute otitis media, 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 preparations are semisynthetic penicillins that are resistant to beta-lactamases (dicloxacillin orally or oxacillin intravenously, also a group of cephalosporins).

Antibiotics for chronic otitis media

Chronic otitis develops, as a rule, with 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 prescription of a general treatment regimen. The destruction of polymicrobial flora requires the use of stronger drugs, sometimes their combinations.

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

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

Antibiotics for otitis media

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

Antibiotic therapy is prescribed, as a rule, when complications develop, the disease is protracted, and there is fluid in the ear cavity. The most suitable drug is selected based on the allergic sensitivity of the patient, his condition and age. If it is impossible to clarify which specific pathogen caused the disease, a systemic antibiotic is prescribed that acts on a wide range of the most typical pathogens of otitis (pneumococcal infection, Haemophilus influenzae, Moraxella, etc.).

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

Antibiotics for purulent otitis media

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

During this period, it is advisable to prescribe rinses with antimicrobial agents (that do not have an ototoxic effect, that is, do not depress auditory function), and introduce 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 media do not differ from those for a standard inflammatory process. Antibacterial therapy is carried out with complex drugs erythromycin, clarithromycin, amoxiclav, ceftriaxone. If complications develop and the disease lasts for a long time, non-steroidal anti-inflammatory drugs (diclofenac, olfen) are added. The well-known first-generation drug ampicillin remains popular, although the use of newer drugs - amoxicillin (flemoxin, ospamox) - is more rational.

Antibiotics for external otitis

Otitis externa affects the skin of the ear, the outer area of ​​the ear 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 external otitis 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. This tampon should be changed every 2.5 hours throughout the day.

It is imperative to include additional treatment methods, such as warm compresses, vitamin therapy, and support for intestinal microflora.

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

Drops for otitis with antibiotic

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

  • hormonal anti-inflammatory drugs (otinum, otipax);
  • antibiotic solutions (chloramphenicol, normax, tsipromed, fugentin);
  • combined solutions combining 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, used by adults and children 3-5 drops three times a day.

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

Drops, as a rule, have a fairly wide spectrum of action. Use topically, 4 drops twice a day in the affected ear, for children 2-3 drops three times a day.

Ear drops containing corticosteroids are prescribed with caution to small children and pregnant women.

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

The best antibiotic for otitis media

The best antibiotic for otitis is determined by the results of a microflora analysis. As for broad-spectrum drugs, special mention should be made of amoxicillin, 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, for complicated diseases 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 discontinuation of antimicrobial drugs can provoke a relapse of the inflammatory process, and in a more severe form.

How to cure otitis media without antibiotics?

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

  • if necessary, antipyretics are prescribed (aspirin, paracetamol);
  • three times a day, the drug otipax - 2 drops in the sore ear;
  • the use of a nasal spray to relieve swelling of the mucous membrane (nasivin, noxprey, etc.);
  • at regular intervals, change ear swabs with a medicinal substance (boric alcohol, vodka, onion juice);
  • for external otitis, lubricate the ear and surrounding area with a bactericidal agent;
  • in case of inflammation, you should drink a lot of liquid, as in case of a cold (raspberry, currant, rose hip, linden tea);
  • Provide the patient with peace and ensure there are no drafts.

At the first signs of otitis, you can try using traditional methods of treating the disease. Even those plants that grow directly in the house, on the window, can be useful: aloe, colanchoe, 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 from the plants and instill 3-5 drops of it into the sore ear.

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

During treatment, you should drink plenty of fluids; it would be a good idea to take multivitamin complexes, as well as medications that strengthen the immune system.

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 not permissible 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, avoiding prolonged presence of water, especially dirty water, in the ear canals.

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

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, specialty - "General Medicine"

Attention!

To make information easier to understand, these instructions for use of the drug “Antibiotics for otitis media” have been translated and presented in a special form based on the official instructions for medical use of the drug. Before use, read the leaflet included directly with the medication.

The description is provided for informational purposes and is not a guide to self-medication. The need to use this drug, the prescription of the treatment regimen, methods and doses of the drug are determined solely by the attending physician. Self-medication is dangerous for your health.

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