American Academy of Otolaryngology-Head and Neck Surgery Foundation GUIDELINES Apps brought to you free pf charge, courtesy of Guideline Central. Enjoy!
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Diagnosis Table 5. Patient Information for Topical Therapy of AOE Frequently Asked Question Answer Are eardrops alone sufficient to treat my infection, or do I also need to take an antibiotic by mouth? Eardrops alone are the most effective treatment for AOE and may contain antibiotics, antiseptics, steroids, or a combination. Antibiotics taken by mouth do not kill most germs that cause AOE and should be used only when infection spreads beyond the ear canal, eardrops cannot get into the ear, or the immune system is weak. Which eardrop is best for treating my ear infection? All eardrops approved for treating AOE (Table 3) are highly effective, with no consistent advantage shown for any one specific drug. If all eardrops are equally effective, why do doctors prescribe different ones? Your doctor will discuss with you the reasoning behind his or her eardrop recommendation, but some of the factors considered include cost, dosing frequency, status of the eardrum, and the doctor's experience. Your opinion and preferences should also factor into this decision. Is there anything I should be sure to tell my doctor that might help in deciding which eardrop is best? Let your doctor know if you had any prior ear surgery, if there is an opening (hole or perforation) of the eardrum, or if an ear tube is in place. If 1 or more of these conditions apply, then your doctor will need to use an eardrop that is approved for use in the middle ear, just in case some of it gets past the eardrum. Also let your doctor know if you have recently used other ear products or medications or if you have had a reaction in the past to a particular eardrop or antibiotic. Last, tell your doctor if you have, or are suspected to have, diabetes, since this could alter management. Once I start using the eardrops, how long should it take until I feel better? Most people feel better within 48-72 hours and have minimal or no symptoms by 7 days. Notify your doctor if your pain or other symptoms fail to respond within this time frame. If it usually takes at least 48 hours to feel better from the eardrops, what should I do for earlier relief ? Pain medicine is especially important to use for relief in the first few days, until the eardrops begin working. Discuss with your doctor which pain medicines are best for you. Pain-relieving (anesthetic) eardrops are not recommended because they are not intended for use during an active ear canal infection and can mask symptoms of a delayed response to therapy. For how long will I need to use the eardrops? Eardrops should be used for at least 7 days, even if you feel better sooner, to prevent relapse of infection. If symptoms persist beyond 7 days, you should notify your doctor and continue the drops until the symptoms resolve for a maximum of 7 additional days.