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Ear, Nose, and Throat Disorders

Bacterial and yeast infection middle ear

09/19/2007

Question:

I have a hole in my right ear drum and while swimming my ear plugs failed and I got infected. My doctor prescribed the antibiotic Augmentin 875mg. twice a-day for 10 days plus Floxin ear drops. After 4 days there was no improvement. I called back and he changed the ear drops to Ciprodex drops 5 drops 3 x day along with Clotrimazole 1% topical sol. 5 drops 3 x day. I`ve had small improvement in my condition. When I put the Clotrimzole drops in my ear they go through the hole in my ear drum and are painful as my middle ear is sensitive. The ingredients in the antifungal solution are Clotrimazole and polyethylene glycol 400. Will use of this hurt my middle ear permanently?Is there a better way to treat this kind of middle ear infection? My doctor says he has had success with this type of ear infection treatment. Is there an oral drug that can clear the ear fungal infection? Please help.

Answer:

That is a difficult problem and the management approach seems very textbook from the information you've provided. There are several medications used for fungal infections and clotrimazole is a commonly used one. As an alternative, oral/systemic antifungal drugs are available - e.g. fluconazole.

It would be worthwhile discussing this with your physician. Topical antimicrobials (e.g. clotrimazole) are nice in that they avoid systemic side effects and go directly to the source of the infection. However, they can have local side effects (e.g. pain with application). In contrast, certain oral antimicrobials can also have side effects (GI upset, allergic reactions, etc) while avoiding local reactions. As a result, the risk-benefit calculations are things that you can ask your physician about.

Best of Luck.

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Response by:

University of Cincinnati Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
Department of Otolaryngology
College of Medicine
University of Cincinnati
Daniel   Choo, MD