Be Ready to Help Treat Swimmer’s Ear

Top Takeaways

• Expect swimmer’s ear treatment to usually include an antibiotic ear drop with or without a steroid.
• Keep in mind that most EYE drops can be used in the ear if needed, but not the other way around.
• Follow your pharmacy policies or insurer’s requirements to calculate days’ supply.

Summer will bring more Rxs for swimmer’s ear.

This bacterial infection is often due to water trapped in the ear canal...and can lead to pain, swelling, itchiness, etc.

Expect that most patients with swimmer’s ear will get a topical antibiotic ear drop (ciprofloxacin, ofloxacin, etc)...with or without a steroid (hydrocortisone, dexamethasone, etc).

Watch for Rxs that don’t specify a dosage form...and help clarify these with your pharmacist.

For example, neomycin/polymyxin/hydrocortisone (Cortisporin) otic SUSPENSION is often preferred over the SOLUTION...since it tends to be less irritating.

Also stay alert for look-alike/sound-alike products. For instance, ciprofloxacin/hydrocortisone (Cipro HC) can be easily mistaken for ciprofloxacin/dexamethasone (Ciprodex).

Keep in mind that most EYE drops can be used in the ear, but not the other way around. And they may cost less than ear drops.

For example, ciprofloxacin 0.2% EAR drops cost about $100-$130/box...vs less than $25/bottle for the 0.3% EYE drops.

Ask patients if they have ear tubes or a ruptured eardrum. If they say yes, alert the pharmacist to clarify if the med is appropriate.

These patients need to avoid NONsterile or ototoxic ear drops (ciprofloxacin/hydrocortisone, etc)...they can cause ear damage, severe irritation, or other issues if they get into the inner part of the ear.

Use the chart below as a quick reference guide.

*This list is not all-inclusive.

Follow your pharmacy policies or insurer’s requirements to calculate days' supply. Many use 20 drops/mL...but some use 15 or 16 drops/mL.

Include a “For the ear” auxiliary label on these Rxs...and send patients to the pharmacist for counseling on proper administration.

For pain, expect the pharmacist to recommend oral acetaminophen or ibuprofen. Help patients find these products on OTC shelves if needed.

Be aware, OTC lidocaine drops (Ear Pain MD, etc) may provide temporary pain relief. But these aren’t recommended in the guidelines.

Note that home treatments withOUT evidence (isopropyl alcohol, white vinegar, etc) aren’t likely to help. And ear candles have been shown to cause harm (hearing loss, ruptured eardrum, etc).

To help PREVENT infection, patients can try earplugs or ear protection headbands (Neoprene, Ear Band-It, etc) while swimming...along with OTC isopropyl alcohol drops (Swim-Ear, etc) after water exposure.