What are PND otic drops?
PND otic drops are a prescription medication combining two antibiotics, neomycin and polymyxin B, and a corticosteroid, hydrocortisone. This combination is specifically formulated to treat superficial bacterial infections of the external auditory canal, commonly known as swimmer's ear or otitis externa. The antibiotics work together to kill or prevent the growth of bacteria, while the hydrocortisone reduces the inflammation, redness, itching, and pain associated with the infection.
Before you begin: Important preparation steps
Proper preparation is key to ensuring the medication works effectively and safely. Following these steps helps prevent contamination and ensures patient comfort.
- Read the label: Always confirm you have the correct medication and understand the prescribed usage and frequency. PND is only for ear use and should not be used in the eyes.
- Wash your hands: Use soap and water to wash your hands thoroughly before and after handling the drops to prevent spreading germs.
- Gently warm the bottle: Holding the bottle in your hands for 1 to 2 minutes will warm the solution to body temperature. Using cold drops can cause temporary dizziness or vertigo.
- Shake the suspension: If your medication is a suspension (indicated by a cloudy appearance), shake the bottle well before each use to ensure the active ingredients are evenly distributed.
- Clean the ear: If there is visible discharge or earwax, gently wipe the outer ear with a clean tissue or sterile cotton ball. Do not insert anything into the ear canal.
A step-by-step guide to administration
Following the correct technique is crucial for the medication to reach the infected area and be absorbed properly.
For adults and children over 3
- Position correctly: Lie down on your side with the affected ear facing upward.
- Straighten the ear canal: Gently pull the outer ear (pinna) upward and backward. This straightens the ear canal, allowing the drops to flow in more easily.
- Instill the drops: Hold the dropper just above the ear canal without touching the ear. Administer the prescribed amount of drops. Never insert the dropper into the ear canal.
- Promote absorption: After instilling the drops, gently massage the small, triangular flap of skin (tragus) just in front of the ear canal.
- Stay in position: Remain lying on your side for a sufficient amount of time, typically several minutes, to allow the medication to penetrate deep into the ear canal.
- Use a cotton wick (optional): Your doctor may recommend inserting a cotton wick into the ear canal to keep the drops in place. This wick should be moistened with the solution and replaced daily as directed by your doctor.
- Repeat if necessary: If you are treating both ears, wait the recommended time between administering drops in each ear.
For children under 3
The administration technique differs slightly for young children due to the shape of their ear canal.
- Position securely: Have the child lie down on a bed or couch with the affected ear facing up. A second person can help by holding the child still.
- Straighten the ear canal: Gently pull the outer ear lobe downward and backward.
- Instill the drops: Carefully place the prescribed amount of drops into the ear canal, avoiding contact with the ear.
- Remain in position: Keep the child in this position for a few minutes to ensure the medication stays in the ear.
Crucial safety considerations and common pitfalls
- Complete the full course: It is vital to finish the entire course of medication, even if symptoms improve quickly. Stopping early can cause the infection to return.
- Do not overuse: Treatment should not exceed the duration recommended by a healthcare professional, as prolonged use can increase the risk of adverse effects, including hearing loss.
- Monitor for allergic reactions: Some individuals, particularly those with chronic otitis externa, may develop a hypersensitivity reaction to neomycin, causing a rash, itching, or swelling. Stop using the drops and contact your doctor if this occurs.
- Never use with a perforated eardrum: If you have a hole or tear in your eardrum, PND drops are contraindicated. Using them with a perforated eardrum can cause serious inner ear damage and potential permanent hearing loss.
Comparison of otic preparations for otitis externa
While PND drops are a standard treatment, other options exist. The table below compares PND with other common topical otic medications.
| Feature | Neomycin/Polymyxin B/Hydrocortisone (PND) | Ciprofloxacin/Dexamethasone | Acetic Acid 2% (Vosol) |
|---|---|---|---|
| Drug Class | Antibiotic/Corticosteroid | Fluoroquinolone/Corticosteroid | Acetic Acid |
| Availability | Generic and formerly brand name (e.g., Cortisporin Otic) | Generic and brand name (e.g., Ciprodex) | Generic and brand name (Vosol) |
| Duration of use | Typically as prescribed by a doctor, often up to 10 days | Typically 7 days | Often used for prophylaxis or mild infections |
| Perforated eardrum? | No, contraindicated due to potential ototoxicity | Yes, generally considered safe | No, contraindicated due to pain and irritation |
| Risk of contact hypersensitivity | Higher risk, especially to neomycin | Low risk | May cause irritation |
| Usage Frequency | As directed by a healthcare professional | Twice daily | 4-6 times daily |
| Key benefit | Effective antibacterial and anti-inflammatory action | Safe for perforated eardrums; low risk of allergic reaction | Cost-effective and useful for prevention |
Conclusion
Using PND otic drops correctly is a straightforward process that plays a critical role in successfully treating outer ear infections. By following the preparation steps—including washing hands and warming the drops—and the specific administration techniques for adults or children, you can ensure the medication reaches the site of infection and works as intended. Always finish the full prescribed course to prevent recurrence and remain vigilant for signs of an allergic reaction or worsening symptoms. If you have a perforated eardrum or experience severe side effects, contact your doctor immediately, as PND is not suitable for all ear conditions. Adherence to these guidelines, in consultation with your healthcare provider, will maximize the benefits of this treatment.
