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Aminoglycoside ear drops ototoxicity — GPhC CRA MCQ

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HardInfection TherapeuticsAminoglycoside ear drops ototoxicityGPhC CRA

A pharmacist is reviewing antibiotic prescriptions in a GP surgery. A patient has been prescribed gentamicin ear drops for otitis externa. The patient's notes indicate a perforated tympanic membrane. What is the most appropriate action?

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Correct answer: C — Contact the prescriber as aminoglycoside ear drops are contraindicated with tympanic membrane perforation

Aminoglycoside-containing ear drops (gentamicin, neomycin) are contraindicated in patients with a perforated tympanic membrane due to the risk of ototoxicity if the drug enters the middle ear. The BNF states that these preparations should be avoided in the presence of a perforation. A non-aminoglycoside alternative such as ciprofloxacin ear drops should be recommended.

Reference: BNF Ear; ENT guidance