Ear infection and risk to baby

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It seems I've had chronic otitis externa for the last few years (itching, redness, inflammation and clear liquid in both ears) and I've finally decided to do something about it.

Contacted the GP and was prescribed otomize ear spray. I then goggled around and found this is not recommended for pregnant women but my prescriber assured me it was fine and not to worry. I'm 5 weeks pregnant and hesistant about taking this treatment but I'm also scared about the ear infection causing any complications.

Have any of you taken otomise in pregnancy, particularly during first trimester?

If I left this untreated and just used olive oil ear drops, is there any risk of the infection spreading to the baby? I don't know much about how ear infections affect fetal health and would appreciate some advice.

This is the website I was recommended by midwife:
https://www.medicinesinpregnancy.org/medicine--pregnancy/
Look up active ingredients on there.

Considering its a spray into your ears I'd think any risk would be absolutely minimal as its essentially a topical rather than systemic treatment. I'd think very very little would get into your blood and the placenta won't have taken over yet so vanishingly little would get into baby if any did at all.

If the GP prescribed it knowing that you were pregnant they would have weighed up the pros and cons of giving it vs not and decided it's right for you.

Most stuff has a blanket 'dont use in pregnancy' simply because it's impossible to trial, so it's easier to just say 'dont'. A GP however knows your circumstances and the way in which you intend to use the medication.

Looking up active ingredients isn't necessarily helpful either as there's a different between Injecting something into your veins vs rubbing some cream on vs. Taking it as a pill or whatever . So it depends how you are using the active Ingredient.

I've had this for years and used otomize when pregnant- dd is now 25 and perfectly fine 😊

I wouldn't worry about a topical ear spray affecting a fetus. Your GP is right.

My issue is I was given conflicting advice from my GPs nurse prescription and clinician and my private GP. But I think it's better for me to take it than not, though I'm still quite nervous as it's so early in the preganncy.

Thank you all for the answers.

Shamelessly boosting for more reassurance from anyone who's used this ear spray or knows more about it

I'm pretty sure a topical application localised to the outer ear wouldn't cause any issues to the baby. It's treating the skin and a minuscule amount will make it to the bloodstream.

I'm not a doctor or prescriber but I am an Audiologist and recommend patients regularly to get a prescription for otomize as it really does work well for otitis externa and is very commonly prescribed. I would trust the GP personally as they will weigh up the risks vs benefits to you in using it while pregnant.

Untreated ear infections do have the potential to get very nasty and spread into the mastoid air cells in the bone surrounding the ear so I would personally try to get it under control if you can. Olive oil alone will do precious little for chronic otitis externa.

Thank you for your input as an audiologist, I really appreciate it.

A severe untreated ear infection can and has resulted in people getting sepsis. Your ear (especially middle ear) is a breeding ground for infection and has a healthy blood supply. Take the medication, the risk is far too high for you not too. It can also affect hearing and infection can spread to the ossicular chain if left untreated also which can result in permanent hearing loss.

far more risky not to take it than to take it

I mean I think sepsis is a little extreme and unlikely 😂.

You're going to get different advice all pregnancy. I had similar with hayfever meds. Doctors prescribed one thing (said my usual wasn't recommended so given a different one), pharmacist lost their nut and lectured me about how 'none were safe' and 'i should be sticking it out for the sake of my baby'.

Midwife gave me that bumps website and said the one GP prescribed me was fine, they would have said a different one but didn't really matter which. Also said while obviously for mild hayfever if you don't need to take anything don't but mine was very severe and while hayfever meds aren't 'proven safe' because you can't ethically test it lots took them and were fine. Severe hayfever meanwhile is proven to result in cortisol stress response which is proven to have an effect on unborn babies. So actually on balance the medication was better for me!

Of course it's better not to need meds but a topical treatment is unlikely to cause harm, your body being stressed about an untreated infection could easily be worse. Weigh up evidence and advice from the professionals and decide which is best for you.

It's more likely for a severe ear infection to lead eventually to meningitis than sepsis I would think.

@FlyingHighFlyingLow as a doctor who has worked in ENT, I can say this is not far fetched. An untreated ear infection can lead to mastoiditis, malignant otitis externa and/or sepsis. A simple UTI can become sepsis if untreated. Same for a bacterial chest infection. Don't underestimate these things, especially during pregnancy when the immune system may not be at its best.

Pharmacists will often have a much higher threshold for recommending medications than doctors. The difference is your GP is likely to have clinical experience of obstetrics where the pharmacist does not. They are also more likely to have been trained to look at things on balance and weigh up the pros and cons depending on the evidence out there. Doctors are expected to take measured risks based on what is in a patient's best interest. Pharmacists are gold in their own right (for instance querying if they are concerned a doctor has made a mistake), but they are generally not trained in weighing up decisions the same way.

Yes a bacterial infection CAN become sepsis, but the risk of that is very low, especially when OP herself states she's had it for years. The poster who said it made it sound like a high risk, which it isn't.

And yes, they are but she didn't really have the right to have the go at me she did when I went in with the GP prescription and maternity exemption certificate and make me feel like a shit mum that didn't care about her baby when I was simply following my GPs correct advice. Had she said she wasn't sure and wanted to check with GP thats fine, ring them up and I can come back later if need be, but don't have a go at me for handing over a prescription I'd been told was fine.

I never said it was a high risk I just said it can happen. Sepsis or meningitis are both much more severe than than taking an already prescribed and approved by the GP medication. The GP has already weighed up the risk to the pregnancy vs the risk of leaving the infection untreated. Also it is reoccurring so treatment has so far undertaken by the OP has been unsuccessful

OP how is your ear?

Hi!

I've got a camera gadget that I've been using to monitor progress and it appears the inflammation is clearing up in both eyes, though there's still more to go. My ears continue to itch but I have been good about not poking/scratching as well as keeping them dry.

Today actually makes my 7th day on this treatment and I don't know how long I should continue using it... the nurse said "use it until the symptoms stop" but the itching is still present 🤷🏿‍♀️

Brilliant news. I would continue the treatment until it is finished or until the symptoms are gone a full week. That way you know the infection isn’t still there and just waiting for the right conditions to start back up again.

a very small amount of olive oil will help with the itch

thanks for the update glad you are doing better :)

Hey, I was wondering if you have any update on this? I have a nasty ear infection and am 10 weeks. GP has prescribed me an ear drop with the same active antibiotic as Otomize which like you I have read is bad and I have scared myself about taking it. Amoxicillin didn't work.