Top Takeaways
- Expect swimmer’s ear treatment to usually include an antibiotic ear drop with or without a steroid.
- Keep in mind that most EYE drops can be used in the ear if needed, but not the other way around.
- Follow your pharmacy policies to calculate days’ supply.
Summer will bring more Rxs for swimmer’s ear.
This bacterial infection is often due to water trapped in the ear canal...and can lead to pain, swelling, itchiness, etc.
Expect that most patients with swimmer’s ear will get a topical antibiotic ear drop (ciprofloxacin, etc)...with or without a steroid (hydrocortisone, dexamethasone, etc).
Don’t be surprised if you see an EYE drop to be used in the ear but alert your pharmacist if you see it the other way around.
Ask patients if they have ear tubes or a ruptured eardrum. If they say yes, alert the pharmacist to clarify if the med is appropriate.
These patients need to avoid NONsterile or ototoxic ear drops (gramicidin/polymyxin B, etc)...they can cause ear damage, severe irritation, or other issues if they get into the inner part of the ear.
Use the chart below as a quick reference guide.
|
Examples of Otic Meds Used to Treat Swimmer’s Ear* |
|||||
|
Drug name |
Dose |
Age |
Ototoxic? |
Can be used with a perforated eardrum or ear tubes? |
Cost estimate per bottle |
|
Antibiotic & Steroid Combination Drops |
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|
Ciprofloxacin 0.3%, dexamethasone 0.1% (Ciprodex) |
4 drops twice daily for 7 days |
≥1 year |
No |
Yes |
$15 (generic) |
|
Clioquinol 1%, flumethasone pivalate 0.02% (Locacorten Vioform) |
2-3 drops twice daily for 7 days |
≥2 years |
Possibly |
No |
$12 |
|
Gramicidin 0.05 mg, framycetin 5 mg, dexamethasone 0.5 mg per mL (Sofracort) |
2-3 drops 3 to 4 times a day for 7 days |
≥18 years |
Yes |
No |
$19 |
|
Antibiotic Drops |
|||||
|
Gramicidin 0.025 mg and polymyxin B 10,000 IU per mL (Soothe) |
1-2 drops 4 times a day for 5-7 days |
≥6 years |
Yes |
No |
$12 |
|
Lidocaine 50 mg and polymyxin B 10,000 IU per mL (Polysporin Plus Pain Relief Ear Drops) |
3-4 drops 4 times a day for 5-7 days |
≥6 years |
Yes |
No |
$15 |
*This list is not all-inclusive.
Follow your pharmacy policies to calculate days’ supply. Many use 20 drops/mL...but some use 15 or 16 drops/mL.
Include a “For the ear” auxiliary label on these Rxs...and send patients to the pharmacist for counselling on proper administration.
For pain, expect the pharmacist to recommend oral acetaminophen or ibuprofen. Help patients find these products on OTC shelves if needed.
Note that home treatments withOUT evidence (isopropyl alcohol, white vinegar, etc) aren’t likely to help. And ear candles have been shown to cause harm (hearing loss, ruptured eardrum, etc).
To help PREVENT infection, patients can try earplugs or ear protection headbands (Ear Band-It, etc) while swimming...along with OTC isopropyl alcohol drops (Auro-Dri, etc) after water exposure.
- Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014 Feb;150(1 Suppl):S1-S24.
- Ellis J, De La Lis A, Rosen E, et al. Approach to otitis externa. Can Fam Physician. 2024 Oct;70(10):617-623.
- Canadian Healthcare Network. Minor ailment counselling tool: Otitis externa. October 20, 2025. https://canadianhealthcarenetwork.ca/minor-ailment-counselling-tool-otitis-externa (Accessed May 15, 2026).