Chloramphenicol ear drops for ear infections (otitis externa)

Name of medicine

Chloramphenicol

Why is it important for my child to take Chloramphenicol?

The information on this page is about the use of chloramphenicol ear drops to treat infections of the outer ear that are caused by bacteria (sometimes called bacterial otitis externa). They are not suitable for ear infections caused by viruses. It is important that you child takes this medicine regularly in the way that your doctor has told you to so that it kills all the bacteria and gets rid of the infection.

What is Chloramphenicol available as?

• Ear drops (5%, 10% chloramphenicol); these contain propylene glycol

When should I give Chloramphenicol

Chloramphenicol is usually given two or three times a day. Your doctor will tell you how often to give it.

• Twice a day: this should be once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7 and 8 am and between 7 and 8 pm.
• Three times a day: this should be once in the morning, once in the early afternoon and once in the evening. Ideally, these times are at least 6 hours apart, for example 8 am, 2 pm and 8 pm.

Try to give the medicine(s) at about the same times each day, to help you remember.

How much should I give?

Your doctor will work out the amount of Chloramphenicol (the dose) that is right for your child. The dose will be shown on the medicine label.

How should I give Chloramphenicol?

Ear drops

Before you give ear drops

• Use the ear drops only in the affected ear, unless your doctor has told you to treat both ears.
• Wash your hands thoroughly with soap and hot water before and after giving the drops.
• You may need help from another adult to give ear drops to your child. One of you can hold the child still and one can give the drops. You may find it helpful to wrap a small child or baby in a blanket to help keep them still.

How to give ear drops

• Shake the bottle and remove the cap.
• Your child needs to have their head tilted to one side. (They could rest their head on a pillow.)
• Put the tip of the dropper just inside the ear hole. Try to avoid touching the nozzle on to the ear. Gently squeeze the drop(s) into the ear.
• Your child should keep their head tilted to one side for a minute or so.
• Wipe the nozzle with a clean tissue after each use.
• If you think the drops didn’t go into the ear, you can repeat the process but do not try more than twice.
• Wash your hands again with soap and hot water.
• Repeat the above steps for the other ear if necessary.

When should the medicine start working?

The medicine will start to work straight away but it may take 2–3 days before your child starts to feel better.

It is important that you give the whole course of Chloramphenicol that your doctor has prescribed, even when your child feels better. This is to make sure that all the bacteria are killed and the infection doesn’t come back.

What if my child is sick (vomits)?

You do not need to worry if your child is sick, as the medicine will still work.

What if I forget to give it?

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

If you usually give it three or four times a day: You do not need to give the missed dose. Give the next dose as normal.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Chloramphenicol by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

Your child is unlikely to get side-effects with Chloramphenicol ear drops, although their ears may sting a little with the first few doses. If you are concerned, contact your doctor.

Can other medicines be given at the same time as Chloramphenicol?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

• Do not put cotton wool or anything else into your child’s ears during the course of treatment.
• Once opened, chloramphenicol ear drops should not be kept for longer than 4 weeks.

General advice about antibiotics

• It is important that your child completes the course of antibiotic. This means that they must take the medicine for the number of days that the doctor has told you to, or until all of the medicine has been taken. If you stop giving the antibiotic too soon, the bacteria that are left will start to multiply again, and may cause another infection. There is also a risk that these bacteria will be ‘resistant’ to the first antibiotic. This means that it might not work next time, and your child might need a different antibiotic, which might not work as well or cause more side-effects.
• Try to give the medicine at about the same times each day, to help you remember, and to make sure that there is the right amount of medicine in your child’s body to kill the bacteria.
• Only give this medicine to your child for their current infection.
• Never save medicine for future illnesses. Give old or unused antibiotics to your pharmacist to dispose of.
• Antibiotics only kill bacteria; they do not kill viruses. This means that they do not work against colds, sore throats, flu or other infections that are caused by viruses. Your doctor will not prescribe antibiotics for these illnesses.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Chloramphenicol and about other medicines used to treat otitis externa (ear infection).

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by March 2016.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.