to be totally shocked by this and if not how do I complain?

[TooTiredToThinkOfAUsername]

DD (6 mths) has been poorly with an ear infection. 5 days ago I took.her to docs because she was having a lot of discharge from her ear. He said she had a perforated ear drum. He took a swab. She was then really quite poorly and I took her back to the docs yesterday. Swab results in. He prescribed gentamicin.

I didn't read the prescription til I got home but then thought I didn't want to give it to her...

Three years ago a colleague happened to tell me that just after her first son was born a pediatrician at the hospital gave him gentamicin without asking her. He is now deaf. She told me this had been caused by the gentamicin and there is a campaign or group of people similarly affected. Just absolutely awful. When I read the prescription when I got home I saw that it was for gentamicin. Oh I thought. That was what was used on X's son. I did a quick check on the internet and the first page of results suggested that yes gentamicin caused hearing loss! But I thought maybe it's like the mmr scare and not actually true. After all a Dr prescribed this! So I got my sister, bil and my Dad (all science phds and bil's sis also gp so they're all super at researching stuff for me!) on the case.

They found that: In general gentimicin can cause hearing loss but not always. In the case when there is a perforated ear drum it will always cause hearing loss as it will destroy the inner ear!!!!! DD has a perforated ear drum and the Dr knew this because he told me in the first place and her ear was still being puss-y. I am absolutely shocked. If a series of chance events and my memory hadn't all come together I would have used the ear drops and would have destroyed her hearing. I'm both quite upset and also so incredibly relieved.

Aibu to feel this way?

If not how do I complain to the docs? I don't want anyone else to experience / risk this!

Go back and talk to your doctor.
You had a swab done this will have said which antibiotics the bacteria are sensitive too it maybe that Gent is the most effective one or even the only one that is effective.
Make sure you understand the risks of not treating a bacterial middle ear infection, there are risks you need to research mastoid abscesses.
Your doctor should have discussed the results and the balancing act needed, but it maybe that gent is the best most effective choice and that the risk of the gent is much less that the risk of a mastoid abscess in a baby of that age.

I would check with the doctor - but wouldn't automatically assume that your relatives (even with their expertise) knew better and or that a complaint should be the first response.

Every medication has potential side effects, you are being a teensy bit PFB about the prescription but I completely agree that if you aren't happy, go back and explain your concerns. If there is an alternative treatment, ask for that.

neither the nhs site or the patient site saywhat you report they say. Might want to actually just talk to the dr instead of blazing in with complaints esp when you havent read your research properly.

I would bemore concerned that your poorly DD isn't being treated for a nasty ear infection than going in all guns blazing.
Seriously make another appointment to discuss with your GP rather than your family members.

You could nip into a pharmacist and see what they say. Normally more clued up on interactions and contra-indications.

I would check- in a "I read it in the PIL leaflet and wanted to double check" kind of way.

If my memory serves the major risk with gentamycin tends to be in preemie cases- they have to give it as a life saving treatment, but deafness is a side effect in such delicate babies- as others have said, IV treatment.

The major ear infection is probably MORE likely to cause hearing loss than the drug to end the infection. Talk to your GP, but get that infection under control ASAP!

Ring and speak to the GP. Locally the use if gentamicin drops for a short course, even in the presence of a perforation of grommets ( which make a hole in the drum) is 100% supported by local ENT specialists.

Please don't withhold the drops from your child - the infection could cause permanent deafness in itself.

The person providing the information has the wrong end of the stick - topical ear drops are absolutely fine! IV gent is what can accumulate and cause problems but if a child is on IV gent they do 12 hourly bloods to monitor levels so this rarely happens.

IV gent is very potent and most not all of course children are only on it for 48-72 hours. I've had it myself and the infection was gone after 24 hours and I was given a 2nd dose and discharged.

Please don't worry - if you have any medical concerns please discuss with a medical professional rather than someone who could possibily misinterpret something that they have read on wiki

FWIW - my information is coming from what I know on a professional level. Part of my job is testing gent levels.

Ooh AuntieDee! Me too! (BMS in micro), I'm assuming from your username you're in transfusion?

Patapouf - deafness is a pretty serious side effect don't you think?

potential side effect. And as knowledgable PPs have explained, not likely in this case.

Imagine if everyone withheld medication from the DCs, that had been prescribed by a qualified medical professional, because of something they read online.

Please dont leave the ear infection untreated whatever you do.

You shouldn't complain, you need to discuss your concerns with the GP. It's also worth speaking to a pharmacist and you can check the BNF (google it) and medicines.org.uk to see if there are any contraindications to the ear drops. If not then your GP was fine to prescribe it but YANBU to question it, but ask your GP rather than the internet!

If your BILs sister is a GP, can she not advise you on this?

From a personal perspective.

Having had perforated ear drums left untreated cause me more damage than any antibiotic would have.

I still suffer now, apparently my ear drum is more scar tissue than other stuff now. But when I do get perforations and pus leaking out they give me drops which clearly say "DO NOT use with perforated drums" I'm pretty sure that's just cause they cause horrendous acute pain when administered, But I discussed this with my ENT specialist and he explained the rationale of the drops being the only hope I have of curing the infection (I'm resistant to most typical orally administered antibiotics now, only for ear infections though if that makes sense?)

You need to slow down and read what other posters are saying.

According to the package insert on the MHRA website, which was updated in March 2014, gentamicin ear drops should not be administered where there is a perforated eardrum.

Go back to your GP OP.

Off label prescribing may be necessary in the case of unmet medical need but there are other antibiotics out there with much lower risk for a 6-month old with a perforated ear drum.

The thing si GPs are SUPPOSED to mentioned side effects to patients before precribing a medicine. They are SUPPOSED to let you know of other aletrnatives because it's always about patient choice rather than 'this is what my GP said I was supposed to do'.

In this case, it is very possible that the drops would have had a really serious effects on this little girl. Because she has a perforated ear drum. A chat with her mum to mention possible side effects and a clear discussion about the medicine would have meant that she is likely to have said No to that one and the GP could have prescribed something else.

GPs aren't gods and they do make mistalkes sometimes. But the lack of talking and informing patients is astonishing.

I have to say, I like too how, the GP is still right for some people, and you need to have a chat and have it confirmed etc... when it's a GP friend that confirmed it shouldn't be used....
Because you see, no one else apart fom a GP can work out from articles if a medication is right oir not.

My daughter has been prescribed gentasone (gentamicin and hydrocortisone) ear drops on several occasions by different ENT consultants for similar. Try and get some reassurance from your pharmacist and/or GP rather than the family research team.

DS1 suffered persistently with ear infections and a perforated ear drum growing up. I also queried the use of Gentamicin with my GP and got explanations as above by other posters. We used it on numerous occasions over the years. He has no hearing deficits although as a teenager he has now developed selective deafness You have to be careful researching on the internet that you understand the full details of the pharmacology!

Thank you for all your replies.

Just a couple of points:

DD is not pfb (though of course very precious nonetheless).

She actually is a lot better today so regardless of whether gentamicin drops cause hearing loss or not I wouldn't want to be giving her an unnecessary course of antibx anyway.

Thank you TheMagnificentFour :) No there was NO discussion about side effects or alternatives or anything. Just a give-these-drops and on your way.

Bil's sister who is a gp said absolutely do not use the drops!

I am planning to ask / question and not go in all guns blazing

It's always interesting to hear ppls views - otherwise why post on mn? But I am surprised at how many ppl seem to think that the Dr MUST be right! He could easily have made a mistake:

He might have forgotten her ear drum was perforated

He might not have known that a perforated ear drum was a contraindication

He could equally have made a considered decision to prescribe the drops anyway (without sharing this thought process with me) but in that case I think asking about it is a fair enough course of action.

I'm glad I asked on mn because now my approach is to question rather than complain :) thank you mn!

This seems odd, there are plenty of other antibiotics your gp could have prescribed instead. At my hospital we use gentamicin intravenously for babies who r at risk of infection. Their blood levels are monitored and it is given slowly. As this decreases the risk enormously. Were they ear drops or a suspension for her to drink?

Listen, my ds has had ear infections from 3 months old. He's 7yo now and at home with an ear infection. At 6 months old they can't tell you how they're feeling, so you can't tell. Also ds at that age if he'd got an infection in one side the other followed fairly quickly.

I once queried him needing antibiotics after perforated ear drum because he takes a lot of antibiotics, and he seemed much better.
My (very experienced and wise) GP pointed out that there was now a hole through which infections could get, and if an infection took in there could be much much more serious than over taking of antibiotics.

Please go and discuss with your GP before you don't give them to her.

And if the GP had to list all the side effects every medicine had you'd never take any of them and appointments would be twice as long. Dd2's just been given vitamin D to take and there's side effects that sound horrendous for that too.

I have already called gp - and just have to wait for them to call me back...

slippermaiden the antibiotics are serving a different purpose in prem babies. Ear drops are totally the right form of gentamicin to give for an ear infection. That's how they get to the site of infection most effectively. The doctor has been diligent in sending a swab to the lab to see which antibiotic the bacteria are most likely to be killed by, which is why they have prescribed it rather than another antibiotic.

It sounds like the doctor could have better communicated with the op as to why they went for this one even though it has potential side effects, but as others have said it is pretty standard to use this in ear infections.