Rating of the best antibiotics for otitis media for 2020

Correct treatment of pain sensations, inflammatory processes of the hearing organs - only under the guidance of specialists. By studying the ranking of the best antibiotics for the treatment of otitis media for 2020, you can choose the right drug using the advice of doctors.

Anatomical structure

The ear is a paired organ of hearing in the temporal part of the head. The main functions are capturing, transmitting sound vibrations, maintaining balance.

There are three parts of the ear: outer, middle, inner.

Outer ear

It is represented by the auricle (cartilaginous tissue), the external auditory canal (24-30 mm). Inside - the skin with glands. Earwax is secreted by the sulfur glands, protects against infections, small insects (specific smell).

Function - collection of sound information, transfer to the next middle department.

Middle ear

Sound waves reach the eardrum (membrane), causing it to vibrate. Behind the membrane of the temporal bone is a cavity (volume 1 cm3), three auditory ossicles - anvil, malleus, stapes. The membrane is connected by ligaments to the handle of the malleus, the head of the malleus is connected to the anvil, the incus is connected to the stapes, and the base of the stapes is the inner part.

Function - transmission, amplification of sounds to the inner ear.

The Eustachian (auditory) tube connects the middle part with the nasopharynx, equalizes the pressure.

A feeling of congestion in the ears is a change in external pressure. To equalize pressure, reduce congestion, you can eat cookies, drink water (make swallowing movements), blow into a pinched nose, yawn several times.

Inner ear (maze)

Components: vestibule, cochlea, semicircular canals. The cochlea and membranous canal are filled with lymphatic fluid. The cavity of the membranous canal consists of cells with hairs that pick up sound vibrations of a certain frequency. The upper frequencies are captured by the hairs of the lower part of the cochlea, the lower frequencies are captured by the upper part. The hairs connect with the fibers of the auditory nerve, through which electrochemical signals enter the brain, where they are received, a sound image is formed.

The ability to perceive different frequencies is lost over time, due to the death of cells in a certain part of the snail.

Otitis

Otitis media is an inflammatory disease of the organ of hearing. It happens one-, two-sided (simultaneous defeat of two organs, typical for young children).

Common symptoms:

• acute ear pain (may increase in the evening, at night);
• decreased appetite, general weakness;
• an increase in body temperature to 38⁰ - 40⁰;
• hearing impairment;
• discharge (purulent);
• throwing back, shaking the head (small children).

There are three main types of otitis media: external (external), middle, internal.

Otitis externa

The main symptoms are added swelling of the auricle, ear canal, increased pain when you open your mouth, the appearance of boils (metabolic disorders).

The reason is improper hygiene, injuries, the presence of sulfur plugs, a violation of the body's metabolic processes.

There are two types:

• limited - inflammation in a small area, boil;
• diffuse - redness of the entire auricle, the auditory canal.

Three reasons for the appearance of diffuse otitis externa are fungal (otomycosis), allergic (dry, wet eczema), bacterial (infection through microcracks, with injuries).

Athletes have “swimmers' disease” after prolonged contact with water, constant pressure changes (diving). It is recommended to use a swimming cap, special earplugs (plugs), which must be constantly treated with antiseptics.

Otitis media

It spreads to the ear section with the tympanic membrane, a cavity with three auditory ossicles, and the Eustachian tube. Children often get sick because of the peculiarity of the anatomical structure of the Eustachian (auditory) tube - in children it is already in diameter, located horizontally (in adults at an angle).

There are two types:

1. Acute otitis media (AOM) - a sharp ear pain (worse at night), an increase in body temperature, a decrease in appetite.
2. Exudative otitis media (EMI) is the accumulation of fluid in a cavity.

Complications may occur: perforation (rupture) of the tympanic membrane, purulent discharge, hearing loss.

Internal otitis media (labyrinthitis)

Inner ear inflammation occurs as a complication after acute, chronic otitis media, infectious disease (tuberculosis), trauma.

Symptoms are nausea, vomiting, tinnitus, dizziness, loss of balance. Confirmation of the diagnosis by a doctor - after passing a clinical blood test, an X-ray of the temporal sinuses of the skull bones. Treatment depends on the severity of the disease, different types of antibiotics are used, bed rest, surgery.

Treatment

Incorrect, untimely treatment of otitis media can lead to deafness, labyrinthitis, and intracranial changes.

Otitis reasons:

• infectious diseases (rhinitis, sinusitis);
• allergy;
• the presence of chronic diseases (diabetes mellitus);
• decreased immunity;
• swimming in pools, reservoirs;
• injuries (improper cleaning, sharp objects).

Be sure to contact your family doctor, doctor - otolaryngologist.

Otitis externa - reducing the swelling of the external auditory canal, relieving inflammation.

Otitis media - pain relievers, antipyretic, anti-inflammatory, antibacterial drugs are prescribed.

Diseases of the inner ear - lesions of the auditory, vestibular apparatus. Symptoms are hearing impairment, noise, dizziness, nausea, loss of body balance, weakness.

Sulfur plug occurs with excessive formation of sulfuric secretion, improper hygiene (irregular cleaning, use of ear sticks). When water gets in, sulfur swells, it can flow into the deep parts of the ear canal - it leads to hearing loss, tinnitus. Mandatory consultation, cleaning with an otolaryngologist.

Swimming in prohibited waters can lead to otitis media if local immunity is reduced.

There are two types of the course of the disease (depending on the duration):

1. Acute - a sharp increase in symptoms (15-28 days).
2. Chronic - occurs due to improper prescription of drugs, untimely treatment (26-30 days, recurrence after 3-4 months).

Antibiotics

The word "antibiotics" means anti - against, bio - life. They are used to treat bacterial diseases, do not affect viral cells.

The first antibiotic "penicillin" was isolated by Alexander Fleming (1928), but it was unstable, destroyed after a short time. The scientists Flory and Chain (1938) increased the resistance of penicillin by creating a salt of penicillin acid. The mass production of penicillin was launched in 1943. Scientists Fleming, Flory, Chain received the Nobel Prize for the discovery of the first antimicrobial compound (1945).

There are two groups of antibiotics (effect on the bacterial cell):

1. Bactericidal - bacteria die, are removed from the body.
2. Bacteriostatic - bacteria lose their ability to multiply, increase their number, but remain alive.

By chemical structure, groups are distinguished:

• beta-lactam - penicillins, cephalosporins, carbapenems;
• macrolides;
• tetracyclines;
• chloramphenicol;
• lincosamides;
• aminoglycosides;
• fluoroquinolones - ofloxacin, norfloxacin.

Penicillins

The active ingredients are penicillin, amoxicillin, amoxicillin + clavulanic acid. They act on most bacteria.

Often cause allergic reactions (itching, urticaria), reduce the effect of birth control pills. Allowed for use in young children, pregnant women. Clavulanic acid is added to protect against resistant bacteria.

Cephalosporins

There are drugs for intravenous, intramuscular use, tablet types (cefixime). It is used for severe forms of infectious diseases in children from birth, pregnant women, lactating women (dose, duration - individually).

Allergic reactions are possible. Release form - tablets, powder (preparation of suspensions), capsules.

Fluoroquinolones

The drugs are ofloxacin, moxifloxacin, ciprofloxacin, levofloxacin. They are used for severe forms of diseases, ineffectiveness of other types of antibiotics.

They can cause disturbances in the formation of cartilage tissue, muscle pain, joint pain, drowsiness, sensitivity to UV rays. Contraindicated in children under 18 years of age, during pregnancy, lactation.

Features of admission - avoid direct sunlight (period of admission, after a course of 3-4 days), do not combine with some drugs (zinc, iron, from increased acidity of gastric juice), drink medicine with plenty of water (250-300 ml).

Macrolides

Drugs - azithromycin, erythromycin, roxithromycin, midecamycin, clarithromycin. They have a bacteriostatic effect - they violate the ability of bacteria to multiply (improvement of the condition occurs in a few days).

Release form - suspensions, capsules, tablets. It is important to follow the conditions of admission - to drink on an empty stomach, not to use other medicines. Reapplication - only after 3-5 months (resistance appears quickly).

New in 2019 is the antibiotic lefamulin (a class of pleuromutilins with a new mechanism of action). Developed by scientists for the treatment of severe pneumonia. Lefamulin has been approved for use by the US government since 2019.

Buying Tips

The main rule is not to purchase any medications without consulting specialists (family doctor, otolaryngologist). The wrong choice of treatment leads to a chronic long-term course of the disease, severe complications (hearing loss, damage to the membranes of the brain - meningitis), the emergence of resistance (resistance) of bacteria to antimicrobial substances.

The doctor selects the active ingredient, concentration, release form, course duration, depending on factors:

• the severity of the disease;
• age;
• the presence of chronic diseases, allergic reactions to the constituent components;
• use of other drugs (interaction is taken into account);
• the use of antimicrobial drugs in the past;
• an analysis is carried out for the sensitivity of microflora to different types of antimicrobial agents (smear, puncture of purulent contents);
• without sensitivity analysis - a broad-spectrum drug;
• the effectiveness of the drug - within 3 days (if the condition worsens, additional doctor's consultation is required, replacement of the antimicrobial drug).

Additional advice when choosing medicines:

1. Buy drugs with a doctor's prescription.
2. Know the name of the drugs, their active ingredient.
3. Choose the appropriate release form (drops, capsules, tablets, syrup).
4. Study the instructions for use, side effects, contraindications.
5. Do not change your own dose, amount, time of admission, duration of treatment.
6. Get acquainted with quality certificates, terms of use, storage conditions.
7. Find out the prices for the prescribed medicine from nearby pharmacies, Internet resources.

Prevention of hearing diseases

It is possible to reduce the incidence of different types of otitis media by following simple rules, expert advice:

• proper hygiene - cleaning the ears without cotton swabs (sulfur plugs may form), separate cleansing of each nostril;
• swimming in clean water bodies (pool, river), drying the external auditory canal with a towel;
• increased immunity (exclude addictions - smoking, a sufficient amount of vitamins, minerals in a varied menu, hardening, walking in the fresh air);
• vaccinate (against pneumococcal, hemophilus influenza, seasonal flu);
• correct treatment of respiratory diseases under the supervision of specialists (rhinitis, sinusitis, sinusitis);
• selection of high-quality headphones (listening to music, playing computer games);
• listen to music using in-ear headphones no more than 2-3 hours per day (1 hour - without a break);
• do not increase the sound volume by more than 60%;
• remove excess sulfur from the ENT doctor;
• infants - do not give pacifiers, food bottles, water for a long time.

Rating of the best antibiotics for otitis media for 2020

All antibacterial drugs are prescription (sold by prescription pharmacies), prescribed individually by a family therapist, otolaryngologist.

For external use

Release form - drops, before instillation, be sure to heat to body temperature - hold the bottle in a compressed palm for 1-2 minutes.

Ciprofloxacin-Solopharm eye and ear drops 0.3% vial-dropper 5ml No. 1

Manufacturer - pharmaceutical company LLC "Grotex" (Russia).

The active ingredient is ciprofloxacin (topical fluoroquinolones). Prescribed for the treatment of eye, ear diseases (otitis externa, postoperative complications).

Application: clean the external passage, drip 3-4 drops 2-4 times a day, lie on your side for 5-10 minutes. The duration of treatment is 5-10 days.

Shelf life - 3 years (after opening - 4 weeks), in a dry, dark place at temperatures up to 25⁰С.

• application in otolaryngology, ophthalmology;
• cost.

• children's age up to 1 year;
• allergic reactions;
• viral keratitis.

Dancil drops eye / ear 0.3% 5ml No. 1

The manufacturer is the Russian company Sentiss.

The active ingredient is ofloxacin (topical) Antimicrobial agent, fluoroquinolone. Assign to adults, children after 1 year of age with ear infections (external, purulent otitis media), infections in ophthalmology.

Application: adults, children after 12 years - 10 drops, 2 times a day (course - 10 days). Children under 12 years old - appointment of an otolaryngologist, outpatient observation.

The patient should lie on his side, after instillation - 5 minutes.

• treatment of eye, ear diseases;
• a wide range of actions;
• cost.

• careful use when driving;
• period of pregnancy, lactation;
• children's age up to 1 year;
• long-term use - control of blood glucose levels, organ function.

Otofa drops usn. 10ml No. 1

Manufactured by a pharmaceutical company - Pharmaster (France). The active ingredient is rifamycin, a local antibiotic. It is prescribed for chronic, acute otitis media, perforation of the tympanic membrane, operations on the middle ear. Adults, children over 12 years old.

Apply 5 drops (for adults), 3 drops (for children) - 3 times a day.It is possible to pour the drug for 2-3 minutes 2 times a day. Course - 7 days (5-10)

Storage conditions - temperature up to 25⁰С. The shelf life is 3 years.

• a wide range of actions;
• use for violation of the tympanic membrane;
• adults, children over 12 years old;
• does not affect driving ability;
• cost.

• May stain clothing
• allergic skin reactions (itching, urticaria);
• not for lactating, pregnant women.

Tsipromed drops usn. 0.3% 10ml

Manufacturer - SENTISS PHARMA, Pvt. Ltd. (India).

The active ingredient is ciprofloxacin, a group of fluoroquinolones. Has a wide range of effects.

It is prescribed for adults, children over 15 years old. It is used in the treatment of: external, middle, internal otitis media, inflammation of the Eustachian tube, damage to ear tissues (before, after surgery).

Application: rinse, dry the external auditory canal, drip 5 warm drops (3 times a day), pull the lobe down and back. Lie on your side (sit with your head thrown back) for 2 minutes, put a cotton swab.

The course of treatment is according to the recommendations of the attending physician, 48 hours after the disappearance of symptoms. Store in a dark place, temperature - up to 25⁰С. Shelf life is 2 years. After opening the bottle - 30 days.

• wide functionality;
• convenient bottle;
• price.

• short shelf life after opening the bottle;
• not for pregnant, lactating women;
• children under 15 years of age;
• allergy to quinolones.

Candibiotic ear drops. 5ml No. 1

Manufactured by Glenmark (India). It is prescribed for different types, stages of otitis media (exacerbation of chronic, acute external, average) for adults, children after 6 years. Combined preparation - consists of four components:

1. Clotrimazole is an antifungal agent.
2. Chloramphenicol is a broad-spectrum bacteriostatic antibiotic.
3. Beclomethasone - against allergies, inflammation.
4. Lidocaine is a local anesthetic (relieves pain).

Instill in the ear canal 3-4 times a day, 4-5 drops. The course of application is 7-10 days.

Storage conditions - dry, dark place, temperature up to + 25⁰С. The term of use is 2 years.

• quickly relieves pain;
• 4 components - action on different reasons;
• the convenience of use;
• cost.

• restriction - children under 6 years old;
• damage to the tympanic membrane;
• allergic reactions.

Oral preparations

They have a wide spectrum of action and are prescribed for infections of various body systems. They differ in the active substance, concentration, rules of admission, form of release.

Unidox solutab tab. dispersion 100mg No. 10

Manufacturer: Astellas / ZiO-Health (Japan / Russia). Form - tablets that dissolve quickly in water (preparation of suspension). The active ingredient is doxycycline, bacteriostatic action.

Assign to adults, children after 12 years (body weight over 45 kg) 1-2 pcs. for 1 time / day. The concentration for children after 12 years (weight - less than 45 kg) is calculated from the ratio of 2.2 mg / kg of body weight 1-2 times per day.

Dissolve the tablet in a small amount of water, can be swallowed whole, divided in small parts, washed down with liquid.

It is necessary to drink the suspension in the first half of the day in a standing position, sitting (to minimize irritation of the esophagus). If irritation of the esophagus occurs, take with food.

Storage conditions - dry, dark place, temperature up to 25⁰С.

• convenient reception (suspension);
• no application to food intake;
• can be used with dairy products.

• possible intolerance to the components;
• it is impossible during lactation, pregnancy;
• restrictions - children under 12 years old;
• high price.

Amoxiclav tab. p.p. 875mg + 125mg No. 14

Manufacturer: Lek d.d. (Slovenia, Germany). Octagonal tablets of yellow-brown color, dispersible (dissolving) in the oral cavity. The active ingredients are amoxicillin, clavulanic acid.

Take 2 tablets at the beginning of a meal in 2 divided doses (adults, children over 12 years old).Swallow tablets, do not chew, can be divided into halves. The duration of the course is an individual appointment.

Shelf life - 2 years at a temperature of + 5⁰ - + 25⁰C. Packing - cardboard box, 7 blisters (2 pcs.).

• acts on many types of microbes;
• clavulanic acid enhances the effect of the drug;
• convenient application schedule.

• additives - aspartame (E951), flavorings;
• allergic manifestations (any drugs of the penicillin type);
• not for children - up to 12 years old;
• pregnant, lactating women - by appointment;

Azithromycin caps. 500mg No. 3

Manufactured by the Russian company "Production of Medicines" (Promed). Gelatinous, hard capsules, white powder inside. Content - azithromycin (macrolide group), bacteriostatic effect on bacteria.

Assign to adults, the elderly, children over 12 years of age (body weight - more than 45 kg) 1 capsule per day. Taking the drug does not depend on food.

Shelf life - 3 years, dark, dry place inaccessible to children.

• comfortable reception;
• prescribed to older people;
• low cost.

• not for children under 12 years old (weight less than 45 kg);
• severe form of renal, hepatic failure;
• allergy to the macrolide group;
• lactation period.

Ciprofloxacin tab. p.p. 500mg No. 10

The manufacturer is the Russian pharmaceutical company OZON LLC. White film-coated tablets, cylindrical. The active ingredient is ciprofloxacin (a group of fluoroquinolones), bactericidal effect.

Application schedule - individual, usually - 1-2 pcs. 2 times / day. Course duration: 7 days - 3-4 months. The maximum daily dose is 1.5 g.

Cautious use: elderly, diagnosis - impaired renal function (concentration adjustment).

Cautious use with preparations of zinc, iron, magnesium - break for 4-5 hours.

Storage - 3 years at temperatures up to 25⁰С, place inaccessible to children. Packaging - cardboard box, 1 contour cell plate.

• great functionality;
• patients with reduced immunity;
• convenient to take - any time;
• low price.

• period of pregnancy, feeding;
• children under 18 years of age;
• allergy to the fluoroquinolone group.

Amoxicillin caps. 500mg No. 16

Manufacturer - Hemofarm (Serbia). Gelatin capsules, yellow (body), red (cap). Inside the capsule is a white granular powder.

The active substance is amoxicillin (a group of 3 generation penicillins). Has antibacterial, bactericidal effect. Great functionality. It is quickly absorbed, not destroyed by the action of gastric juice.

Individual dosage regimen, duration. Children under 5 years old - 125 mg, 5-10 years old - 250 mg, over 10 years old, adults - 500 mg once a day.

Cardboard box, 2 blisters of 8 capsules. Storage - 3 years, temperature - no higher than 25⁰С.

• a wide range of actions;
• possible for children when adjusting the dose;
• pregnant, lactating women - under the supervision of a doctor;
• low cost.

• the presence of dyes;
• individual reactions are possible;
• not recommended for patients with liver diseases.

Output

Antibiotics should be taken strictly on the recommendation of the attending physician, without independently changing the concentration, regimen, and course duration. By observing the rules for the prevention of respiratory diseases, leading a healthy lifestyle, you can minimize the need to be treated with antimicrobial drugs.