Ear Drops Best for Swimmer's Ear

New Guidelines Recommend Ear Drops First, Not Oral Antibiotics, to Treat Swimmer's Ear

Medically Reviewed by Louise Chang, MD on March 31, 2006

March 31, 2006 -- Ear drops are the best medicine for swimmer's ear, according to the first-ever recommendations on how to treat the common condition.

Swimmer's ear affects about one in every 100-250 Americans each year and is caused by water trapped in the ear canal. Although associated with swimming and areas with warmer climates and higher humidity, any person can get swimmer's ear, also known in medical terms as acute otitis externa.

The trapped water causes bacteria in the ear canal to multiply and leads to infection and inflammation of the external ear canal. Symptoms include pain, swelling, and itching of the external ear canal and outer ear.

The guidelines recommend using ear drops to treat swimmer's ear locally and say that oral antibiotics should not be used unless the infection has spread outside the ear canal or if there are other symptoms that call for oral antibiotics.

A panel of experts from the fields of head and neck surgery, pediatrics, family medicine, infectious disease, internal medicine, emergency medicine, and medical informatics compiled the guidelines based on a review of research on swimmer's ear.

Ear Drops Best for Swimmer's Ear

The results showed that swimmer's ear is often severe and can interfere with work or leisure activities. With proper therapy, the pain usually improves after one day and the condition completely resolves within four to seven days.

Experts say antiseptic and antibiotic ear drops are the preferred treatment for most cases of swimmer's ear because they offer safe, prompt, and effective relief while not promoting antibiotic-resistant bacteria.

Oral antibiotics are not recommended for initial treatment of swimmer's ear because overuse of antibiotics can increase the spread of antibiotic-resistant bacteria, are associated with more side effects, and may be less effective than ear drops.

Other recommendations include:

  • People with eardrum tubes or perforated eardrums should use one of the newer antibiotic ear drops that are approved for this purpose and do not cause hearing loss.
  • Ear drops are only effective when used properly. Health care providers should inform patients how to use ear drops, clean obstructing debris from the ear canal, and insert a wick, when necessary, to allow the drops to enter the ear canal if it is very swollen.
  • Ear candles are not recommended for treating swimmer's ear because they have never been proven effective and have dangerous side effects that include burns and perforated eardrum.
  • Patients should avoid water sports for 7-10 days during treatment.