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Dr Mike, PharmD
Dr Mike, PharmD, Pharmacist
Category: Pharmacy
Satisfied Customers: 83
Experience:  Doctor of Pharmacy, 20+ yrs experience, trained at the University of Iowa
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My daughter had a small rock removed from her ear and was

Customer Question

hi my daughter had a small rock removed from her ear and was prescribed Neomycin and Polymyxin B Sulfates and Hydrocortisone Otic Solution, USP 5 drops 3 times a day. every time i give the drops she screams in pain and it smells like necrotic tissue. is that to be expected or should i discontinue use and take her to the er or call the prescribing Dr in the morn?
Submitted: 1 month ago.
Category: Pharmacy
Expert:  Dr Mike, PharmD replied 1 month ago.

Hello, and thanks for the question. I'm DrMike, a pharmacist with over 20 years experience. I'm glad to help you today.

The eardrop 'solution' that you refer to has a low pH (is quite acidic) and can be irritating to the the inflamed tissue of an ear infection. In fact it should not be used if the eardrum is punctured, as the neomycin component can interfere with future hearing. If there is no puncture, this is not an issue.

There is a suspension form of this medication that has a much higher pH around 5 or so, that is much more comfotable when administered.

(If there are concerns about an ear puncture or perforation, a medication like Ciprodex or Cipro HC or similar that does not cause potential ear toxicity if it reaches the inner ear.)

So, my first suggestion assumes that the eardrum is not perforated. Improvement with her current therapy will occur and continue within 2-3 days IF she can tolerate it. If absolutely not, then I would switch to suspension, which is much less irritating. If the eardrum is perforated, I would be switching to an entirely different medication altogether as mentioned above.

I hope this helps and addresses your concerns. I surely hope your daughter feels better soon. Please do ask if you need further clarification. -DrMike

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