Which ear drops help in the treatment of outer ear infections?

Photo of a girl having her ear examined by a doctor (PantherMedia / Wavebreakmedia ltd) Some prescription-only ear drops can effectively relieve earache caused by an outer ear infection (otitis externa). There is no evidence that over-the-counter disinfectant ear drops are as effective.

Outer ear infections are among the most common causes of earaches. They are usually caused by bacteria. If the infection only lasts a few days or weeks, it is called acute otitis externa. Painkillers and disinfectant ear drops are some of the more common treatments that are available in pharmacies without a prescription. But prescription-only ear drops – for instance, containing antibiotics or steroids – are often used too.

Research on treatments for outer ear infections

Researchers from the Cochrane Collaboration (an international network of researchers) analyzed the results of 19 randomized controlled trials that tested various treatments for outer ear infections. Almost 3,400 children and adults with an acute outer ear infection took part in these good-quality studies. The researchers didn’t include studies on chronic outer ear infections.

Most of the studies were done in specialized ENT (ear, nose and throat) departments. The problem with that is that many people go to their family doctor when they have an earache – they are referred to specialized ENT practices or clinics only if the infection is especially severe. So it might not be possible to apply the results of the study to all patients who have an outer ear infection.

Also, the treatments in the various studies weren't always done in the same way. Because of this, it isn’t possible to draw any reliable conclusions about the advantages and disadvantages of the various ear drops and sprays.

Evidence of an inflammation-reducing effect

Still, it was found that prescription-only ear drops (containing antibiotics or steroids) seemed to effectively relieve the symptoms of outer ear infections. Some studies also looked at combinations of different types of drugs, but none of the treatments were found to be better or worse than others.

There’s no evidence that over-the-counter disinfectant ear drops are as effective as ear drops containing antibiotics or steroids.

Doctors can help people decide which prescription ear drops are most suitable.

All ear drops can also have side effects such as burning sensations or rashes. But side effects are unlikely if you use the ear drops properly. If you aren’t sure how to use them, you can consult the package insert or ask your doctor.