Are Antibiotic Eye Drops Safe To Use In The Ear?

In our latest question and answer, the pharmacist discusses whether or not antibiotic eye drops can safely be administered in the ear.

Question

My son got an ear infection and got a prescription ear drops. When we arrived home, I noticed that the drops are neomycin;polymyxin B sulfates and dexamethasone ophthalmic suspension eye drops. The doctors office told me that these eye drops are good for ears too. I thought for ears you have to use the otic solution! Now I am afraid to use these drops. Please advise. Thank you

Asked by Tony On Sep 14, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 14, 2022
Last updated May 05, 2024

Key points

  • Antibiotic ophthalmic drops (i.e. eye drops) can safely be used in the ear, but not the other way around (ear drops cannot be used in the eye).

Answer

Yes, eye drop formulations, like Neomycin/Polymyxin B/Dexamethasone, can safely be used in the ear. However, it doesn't work the other way around... ear drop formulations of a drug CAN NOT be used in the eye. There are a couple of reasons for this:

  • First, eye drops are sterile solutions. This means that the solution was manufactured under certain conditions to ensure that they are bacteria free. While most ear drops are also sterile solutions, there are a couple of products that are not.
  • The second and more important difference between eye drops and ear drops is the pH of the solutions or suspensions of the products. Ear drops are generally more acidic than eye drops and could cause serious damage if accidentally used in the eye.

Some doctors may prefer a particular combination of drugs found in an ear drop that is not available in an eye drop. This can also happen when an ear drop is out of stock but is available in the eye drop formulation. Regardless, it is safe to use this eye drop solution in your son’s ears.  

Below is some additional information about how to administer drops into the ears.

Administering Drops Into The Ears

Regardless if you are using drops specifically made for the ears or using eye drops for the ears, the administration of the drops in the ear is the same. These directions are adapted from the American Academy of Pediatrics.

  • Both the child and caregiver should wash their hands with soap and water.
  • Roll the bottle between your hands.  This will warm the medication up and also mix the medicine if it is a suspension formulation.
  • Have the child lie down with the affected ear facing up.
  • If there is any drainage, gently clean the OUTER ear with a clean cloth and dry.
  • Gently place hand on child’s forehead or cheek to keep the child still.
  • Place dropper above the child’s ear canal. The dropper should not touch the ear, but be above it.
  • For children under 3 years of age, pull earlobe downward and back. For children over the age of 3 years old, pull flap upwards and back. 
  • Instill prescribed numbers drops by gently squeezing the bottle. The child should remain still for at least 1 to 2 minutes but preferably 2 to 5 minutes. 
  • Gently rub front of ear to help medication be absorbed.
  • Rinse dropper tip and replace the cap.
  • Wash your hands.

For young children who cannot remain still for the medication to be absorbed, a cotton ball may be placed in the affected ear(s) gently.  This should be removed and changed each time the medication is administered.  

Final Words

To reiterate, while it may not seem correct, eye drops CAN be used in the ear. It is safe to use the ophthalmic eye suspension that your son was prescribed for his ear infection.  However, ear drops CAN NOT be used in the eye.

Anytime something does not feel or look right to a patient regarding his or her medication, it is always a good idea to check with the pharmacist or the prescriber of the medications.  Though rare, mistakes do happen and it is better to double-check.

References

  • How to Use Ear Drops, Safe Medication
  • Clinical practice guideline: acute otitis externa, PubMed
  • Otic drug delivery systems: formulation principles and recent developments, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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