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Are chloramphenicol ear drops good for ear infection?

Posted on  February 14, 2021, Edited by Jason, Category  

What are chloramphenicol ear drops?

1. Definition

Chloramphenicol ear drops are indicated for the treatment of otitis externa and acute and chronic otitis media caused by sensitive bacterial infections. This product is a colorless or slightly yellow viscous clear liquid; the taste is extremely bitter; it can be mixed with water at will. Occasionally allergic reactions appear.

Although this product is a topical medication, chloramphenicol has a serious bone marrow suppression effect. Pregnant and lactating women using it may also cause serious adverse reactions in newborns and nursing infants. Therefore, pregnant women and lactating women should use it with caution. Combination with lincomycins or erythromycins and other macrolide antibiotics can cause antagonism, so the combined application is not suitable.

BALLYA provides a chloramphenicol test to tell you if there are chloramphenicol residues in dairy products you eat every day.

2. Pharmacological toxicity

This product is a chloramphenicol antibiotic. It has a broad-spectrum antimicrobial effect in vitro, including aerobic gram-negative bacteria and gram-positive bacteria, anaerobic bacteria, rickettsia, spirochetes and chlamydia.

It has a bactericidal effect on the following bacteria: Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis.

It only has antibacterial effect on the following bacteria: Staphylococcus aureus, Streptococcus pyogenes, Streptococcus viridans, Group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Typhoid fever, Salmonella paratyphi, Chi Anaerobic bacteria such as Gagella and Bacteroides fragilis.

The following bacteria are usually resistant to chloramphenicol: Pseudomonas aeruginosa, Acinetobacter, Enterobacter, Serratia marcescens, Indole-positive Proteus, Methicillin-resistant Staphylococcus, and Enterococcus.

This product is a bacteriostatic agent. Chloramphenicol is fat-soluble. It diffuses into bacterial cells and reversibly binds to the 50S subunit of the bacterial ribosome, hindering the growth of the peptide chain (possibly due to the inhibition of the effect of transpeptidase), thus inhibiting the formation of the peptide chain, thereby preventing protein synthesis.

What is otitis media?

What-is-otitis-media
What-is-otitis-media

Otitis media is an inflammatory disease that affects all or part of the middle ear (including the Eustachian tube, tympanum, tympanic sinus, and mastoid air chamber), and it is more common in children. It can be divided into two categories: non-suppurative and suppurative. Non-suppurative ones include secretory otitis media, baro-injury otitis media, etc. Purulent ones are divided into acute and chronic. Specific inflammation is rare, such as tuberculous otitis media.

1. Causes

Acute otitis media is an acute purulent inflammation of the middle ear mucosa, which is infected by the Eustachian tube. After catching a cold, the inflammation of the pharynx and nose spreads to the Eustachian tube, and the mucosa of the pharyngeal mouth and the lumen of the Eustachian tube appear congestion and swelling, and the movement of cilia is obstructed, causing otitis media. Common pathogenic bacteria are mainly pneumococcus and Haemophilus influenzae.

  • The nasal mucus contains a lot of viruses and bacteria. If the nostrils on both sides are pinched and blown, the pressure will force the nasal mucus to squeeze out to the eustachian tube and cause otitis media.
  • Avoid swallowing water into your mouth when swimming, lest water enter the middle ear through the nasopharynx and cause otitis media. For tympanic membrane perforation caused by trauma, it is forbidden to drip any water-like liquid, so as not to affect the healing of the wound. Sterilizing cotton balls can be used to block the external ear canal to avoid infection and induce otitis media.
  • If the infant is feeding on the supine position, because the infant’s Eustachian tube is relatively straight with a short lumen and a wide inner diameter, milk can choke into the middle ear through the Eustachian tube and cause otitis media.
  • Smoking, including passive smoking, can also cause otitis media. Smoking can cause systemic arteriosclerosis, especially when the nicotine in cigarettes enters the bloodstream, spasm of small blood vessels, increases blood viscosity, and hardens the arterioles that supply blood to the inner ear, causing insufficient blood supply to the inner ear and severely affecting hearing.
  • Listening to rock music with big decibels with headphones for a long time can easily cause chronic otitis media.

2. Clinical Feature

A. Suppurative otitis media

a. Acute suppurative otitis media
The symptoms of middle ear inflammation caused by purulent bacterial infection are mainly earache and pus. Children's systemic symptoms are more pronounced than adults, including fever and vomiting. Serious complications include intracranial complications, such as meningitis and brain abscess. Other complications include labyrinthitis and facial nerve palsy.

b. Chronic suppurative otitis media
It refers to chronic purulent inflammation of the middle ear mucosa, periosteum, or deep bone. This disease is more common in clinical practice. The main clinical manifestations are intermittent or continuous discharge of pus, tympanic membrane perforation, and hearing loss. In severe cases, it can cause intracranial and extracranial complications.

  • Systemic symptoms vary in severity. There may be cold, fever, fatigue, and loss of appetite. Children have severe systemic symptoms, often accompanied by vomiting, diarrhea and other gastrointestinal symptoms. Once the tympanic membrane is perforated, the body temperature gradually drops and the systemic symptoms are significantly reduced.
  • Earache. There will be gradually worsening deep ear pain, such as throbbing pain or tingling. It can radiate to the head or teeth on the same side. Earache worsens when swallowing and coughing. People with severe earache can't sleep at night and become irritable. After the tympanic membrane is perforated and pus is discharged, the earache suddenly decreases.
  • Ear discharge is the main symptom of this disease, which can be mucus, sticky pus or pure purulent. Non-dangerous type discharge is thinner and has no smell. Dangerous pus is not much, but thick, mostly pure purulent, and accompanied by a peculiar smell.
  • Hearing loss and tinnitus. You will begin to feel fullness in the ears, and then gradually lose hearing, accompanied by tinnitus. The deafness of the earache can be ignored. Some patients may be accompanied by dizziness, but deafness is reduced after perforation.
  • Deafness varies in severity, because it is mostly caused by one ear and is easily overlooked. Generally conductive deafness.

B. Non-suppurative otitis media secretory otitis media

a. Hearing loss
Most acute secretory otitis media can cause hearing loss after catching a cold, descending on an airplane or diving, and may have "self-recreation". The severity of deafness in patients with chronic secretory otitis media often fluctuates. When the tragus is compressed or the head position is changed, the hearing can be improved. When the middle ear effusion is thick, the hearing will not change due to the change of the head position. Children often do not have the main complaint of hearing loss, which is manifested as ignoring parents' calls, lack of concentration, or requiring excessive volume when watching TV.

b. Earache
Acute secretory otitis media may have mild earache, and chronic secretory otitis media may have earaches when secondary infections occur.

c. A feeling of fullness or occlusion in the ear.

d. Tinnitus
It is generally not serious, but can be intermittent, and the sound of breath can be heard when the head moves, yawns or blows the nose. A small number of patients with secretory otitis media can also have water in the ear, but the duration is very short, only a few hours or about a day.

e. Otoscope examination
In the acute phase, there are radial veins around the tympanic membrane. The tense part of the tympanic membrane is inverted, which is manifested as the shortening, deformation or disappearance of the light cone; the malleus stem shifts backward and upward; the malleus short process is obvious.

When the tympanic effusion occurs, the tympanic membrane loses its normal luster and is pale yellow, orange-red or amber; in chronic patients, the tympanic membrane is milky white or gray-blue and opaque.

If the secretion is serous and does not fill the tympanum, the liquid level can be seen through the tympanic membrane, which is a concave upward curved line. Sometimes bubbles can be seen through the tympanic membrane. The bubbles increase after the eustachian tube is inflated. If there is more fluid in the tympanic cavity accumulates, the tympanic membrane will protrude and the tympanic membrane activity will be limited.

3. Treatment

  • Actively treat upper respiratory tract infectious diseases, such as chronic sinusitis and chronic tonsillitis.
  • Medication
    What drops are good for ear infection? Topical medication is mainly for simple type of ear infection, such as antibiotic aqueous solution or a mixture of antibiotics and steroid hormone drugs, such as 0.25% chloramphenicol solution, chloramphenicol ear drops, chloramphenicol cortisone solution, ofloxacin ear drops, etc., can be used to treat otitis media and external auditory canal Yan etc.
  • Precautions for topical medication
    Before medication, clean the external ear canal and the pus in the middle ear cavity. Use 3% hydrogen peroxide or boric acid to clean it, then wipe it with a cotton swab or suck up the pus with a suction device before dripping. Use water solution when the amount of pus is large, and boric acid alcohol when the amount is small.
  • A large perforation of the tympanic membrane affects hearing, so tympanoplasty or tympanoplasty is feasible.

How to treat otitis media in dogs?

How-to-treat-otitis-media-in-dogs
How-to-treat-otitis-media-in-dogs

Many owners do not know about otitis media in dogs, so when a dog shows some symptoms of otitis media, the owner may not even know what happened to the dog. Otitis media in dogs refers to all or part of the inflammatory lesions that occur in the middle ear canal of dogs. Otitis media in dogs can be divided into two types: serous otitis media and suppurative otitis media, which are classified according to the exudate of the dog's middle ear. Since otitis media may cause serious damage to dogs, timely treatment is extremely important.

Some dogs are more susceptible to otitis media. These dogs usually have longer ears and more ear hairs, such as cocker spaniels, beagles, and poodles. If you keep these breeds of dogs, the owner needs to do a good job of daily protection, so as to prevent the dog from otitis media.

Anything that disrupts the balance between the secretions in the dog's ears may cause otitis media. For example, it is most common that water enters the ears when taking a bath, or dirty water enters the ears when swimming, or even foreign objects enter the ears, or there are parasites and insects, which may cause otitis media in dogs. In most cases, the auricle and ear canal are inflamed in the dog, which belongs to otitis externa. If the otitis externa is not cured, it is likely to become otitis media.

1. Symptoms

The most obvious symptoms of otitis media are ear pain and itching. Dogs will constantly want to scratch their ears with their paws when they are sick. If the dog is allowed to scratch his ears casually, the dog is likely to injure his ears due to constant scratching, resulting in bleeding and hematoma.

2. Treament

How to use ear drops? After the initial cleaning, it is necessary to treat the dog's inflammation according to its cause. If it is caused by bacteria, anti-inflammatory drugs and antibiotics may be needed. And the fungal infection requires to be specialized antifungal drugs. If it is a foreign body, it is easier to deal with. In the follow-up, every day, the owner needs to give the dog medicine and clean the ears. Generally speaking, you need to persist for at least two weeks. Commonly used ear drops are chloramphenicol ear drops and ofloxacin ear drops.

How to treat otitis media in cats?

Feline purulent otitis media is a common and frequently-occurring disease in cat ear diseases. This is due to the special physiological anatomy of the middle ear cavity. That is, the middle ear cavity communicates with the nasopharynx through the Eustachian tube. Therefore, when suffering from inflammation of the upper respiratory tract, the infection spreads easily to the Eustachian tube, and bacteria enter the middle ear cavity through the Eustachian tube and cause suppurative otitis media.

1. Symptoms

It will show irritability, loss of appetite, slow response to external stimuli, unwillingness to move, fatigue, itchy ears, and forefoot to keep pulling ears. Most cats have no abnormalities in body temperature, pulse, and respiration. During ear examination, it is found that the unilateral or bilateral ear canal discharge is serous, mucus, and sometimes vicious and dirty purulent liquid, and has a special fishy smell. Individuals have gastrointestinal symptoms, vomiting, diarrhea, constipation, and decreased appetite.

2. Treatment

A. Local therapy

Wash the ears with 3% hydrogen peroxide, clean the ear canal, and remove the pus twice a day; keep the eustachian cavity unobstructed, instill chloramphenicol ear drops.

B. Antibiotic therapy

Use sufficient systemic antibiotic. Penicillin 800,000 units/time, gentamicin 80,000 units/time, intramuscular injection twice a day. Feline purulent otitis media is treated with conservative treatment. Clean the ear canal, keep the eustachian cavity unblocked, use systemic antibiotics, and basically the cat will be cured in two weeks of treatment.

Conclusion

Chloramphenicol ear drops are mainly used for ear infections. It is not only effective for humans, but also very important for our pet cats and dogs. But when we apply this chloramphenicol ear drops to cats and dogs, we need to consult a professional veterinarian, and pay attention to the usage and chloramphenicol dosage.

References

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