A few days ago, a patient came to the hospital for otitis media, and because the original ofloxacin ear drops were out of stock, the doctor prescribed levofloxacin eye drops, which caused questions from the window pharmacist.
So can levofloxacin eye drops act as ear drops?
Levofloxacin eye drops are suitable for blepharitis, blepharitis, conjunctivitis, dacryocystitis and so on caused by sensitive bacterial infection.
Ear drops are suitable for otitis externa, myringitis and otitis media caused by sensitive bacteria.
Although we are aware of the difference in the design purpose of eye drops and ear drops, whether eye drops can be used as a substitute for ear drops, let's discuss the preparation process, concentration, PH, excipients and physiological structure of the ear canal.
Preparation process
Both eye drops and ear drops are topical preparations, but eye drops are produced in a more stringent and sterile environment. The process requirements for ear drops are relatively less stringent.
Concentration
The concentration of levofloxacin eye drops is 5ml: 24.4mg, while the concentration of ofloxacin ear drops is 5ml: 15mg, the concentration of eye drops is lower than that of ear drops, so the treatment effect on otitis media is also not good.
pH aspect
The pH value of the eye drops is 6.0-7.0, and the pH value of the ear drops is 4.5-6.0, which is more in line with the requirements of weak acidity of the external auditory canal.
In terms of excipients
In order to prevent microbial contamination and reproduction during use, the lowest effective dose of benzalkonium chloride is generally added as a bacteriostatic agent, and the solvent of ear drops sometimes contains ethanol, which can enhance penetration, promote drug absorption, and also have bactericidal effects, but it is more irritating to the local.
The physiological structure of the ear canal determines that the ocular preparation is not fully suitable for the ear canal. Because eye drops are water-soluble and less volatile, although they can bring the drug into the deep ear canal in liquid form, it may cause fluid accumulation in the deep ear canal, so that the deep part of the ear canal is in a relatively humid environment, which is not conducive to drainage. Ear drops are generally made of alcohol as a carrier, which can be volatilized well, and after bringing the liquid into the ear, it will not cause too much stimulation to the local area, and can be fully drained, which is conducive to the discharge of pus, and is conducive to the role of antibacterial drugs in the middle ear.
For this reason, levofloxacin eye drops are often used to treat conjunctivitis and, although mild, are not recommended as ear drops. If there is a special ear drop, it is recommended to use ear drops, which has a better effect on the treatment of otitis media.
If there are really no ear drops,
Can I use eye drops instead?
Eye drops can be used to drop the ears because the drug contained in the eye drops is relatively low and will not harm the ears if they are dropped into the ears. However, because of its low drug concentration, it is less effective. Due to its high process requirements, eye drops generally have no obvious irritation to mucous membranes and skin, and there are few uncomfortable symptoms such as pain and itching after ear drops. However, because the antibacterial effect of levofloxacin eye drops is weaker than that of ear drops, ofloxacin eye drops should not be used for the treatment of acute otitis media.
So can ear drops be used as eye drops?
Although eye drops can replace ear drops to relieve temporary needs, ear drops usually cannot be used to drop eyes, because the concentration of ear drops will be relatively high, and the use of eye drops will cause certain irritation and damage to the eyes. In addition, the pH of the two may not be the same, and the eye has a higher pH demand. If the pH is too high or too low, it will cause intolerance of the ocular surface, and obvious irritation symptoms will appear, including pain, soreness of the eyes, etc.
Finally, if there is inflammation in the ear, it is recommended to go to the hospital to identify the cause before treatment, and avoid self-medication. The safest course of action is to use medications designed for the ear under the guidance of a doctor. At the same time, it is also very important to keep your ears clean and dry and avoid irritating them with sharp objects. Pay attention to the cleanliness and health of your ears in your daily life, and it is recommended to clean your ears regularly with warm salt water, once or twice a week, to help maintain ear hygiene and prevent infection.
Reviewer: Cui Qiang, chief pharmacist of Dalian Women and Children's Medical Center
Author: Yu Hong, deputy chief pharmacist of Dalian Women and Children's Medical Center