What drops (if any) are safe when the TM is perforated or cannot be assessed due to swelling? I have heard mixed answers to this. Some say no drops, some say no steroids, some say it doesn't matter...
He mentions using eye drops in the ear. I have had a pharmacist request a change to tobramycin drops. I was concerned about ototoxicity if there is a perforation. Thoughts?
Quinolone drops are safe in children because the effect is mainly topical, and they're safe with perfs/tubes (as are steroids). Besides canal swelling, another shout-out for steroid drops is in patients with bloody otorrhea (which almost always represents granulation tissue that will melt away with the steroids). We didn't mention it, but the steroid eyedrop I usually use is prednisolone (aka Pred Forte). As to the issue of using an aminoglycoside-containing drop (or any other ototoxic component) in a patient that has (or might have) a perf/tube: imagine yourself explaining to the jury why you used a medicine referred to as "ear-toxic" in the ear... enough said. Cortisporin has not one but TWO ototoxic components: polymyxin B and neomycin.
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Brian T. - January 7, 2018 11:33 AM
What drops (if any) are safe when the TM is perforated or cannot be assessed due to swelling? I have heard mixed answers to this. Some say no drops, some say no steroids, some say it doesn't matter...
Christine A. - January 13, 2018 9:55 AM
What is the safety of quinolone drops in children?
Joseph P. - January 21, 2018 11:59 AM
He mentions using eye drops in the ear. I have had a pharmacist request a change to tobramycin drops. I was concerned about ototoxicity if there is a perforation. Thoughts?
Clayton F. - December 29, 2018 1:38 PM
Quinolone drops are safe in children because the effect is mainly topical, and they're safe with perfs/tubes (as are steroids). Besides canal swelling, another shout-out for steroid drops is in patients with bloody otorrhea (which almost always represents granulation tissue that will melt away with the steroids). We didn't mention it, but the steroid eyedrop I usually use is prednisolone (aka Pred Forte). As to the issue of using an aminoglycoside-containing drop (or any other ototoxic component) in a patient that has (or might have) a perf/tube: imagine yourself explaining to the jury why you used a medicine referred to as "ear-toxic" in the ear... enough said.
Cortisporin has not one but TWO ototoxic components: polymyxin B and neomycin.