Topical Antibiotic — Otitis Externa Pregnancy: Safety in pregnancy and lactation has not been established. Chloramphenicol may be absorbed systemically following use of ear drops and may cross the placenta and appear in breast milk; therefore this product is not recommended for use during pregnancy and lactation.

Chloramphenicol Ear Drops

Brand names: Chloromycetin Ear Drops

Used in: Acute Red Eye

Chloramphenicol ear drops are a topical broad-spectrum antibiotic preparation used for bacterial otitis externa.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 3 to 4 drops into the affected ear

Route: Topical - ear drops (auricular use)

Frequency: 2 to 3 times daily for up to 1 week

Adults, children and the elderly: apply 3-4 drops into the affected ear 2-3 times daily for up to 1 week. Following administration patients should be advised to lie down with the affected ear uppermost for a minimum of 10 minutes; after this time cotton wool may be inserted into the ear and normal activities resumed. Infants: only use if considered essential by the physician. Avoid use for more than 1 week as this may result in sensitivity to chloramphenicol or the emergence of resistant organisms. In severe infections topical chloramphenicol should be supplemented with appropriate systemic treatment. Where used on a long-term or intermittent basis it may be advisable to perform a routine blood profile before therapy and at appropriate intervals thereafter. Product: Chloramphenicol 10% w/v Ear Drops (contains 0.9 g propylene glycol per 1 mL).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Perforated ear drum
Myelosuppression during previous exposure to chloramphenicol
Known personal or family history of blood dyscrasias including aplastic anaemia

Side effects

Hypersensitivity reactions including angioedema, anaphylaxis, urticaria and fever
Vesicular and maculopapular dermatitis
Bone marrow depression
Aplastic anaemia (rare, reported following topical use of chloramphenicol, with reports of death)
Blood dyscrasia (occasional)

Interactions

Avoid concomitant administration with other drugs liable to depress bone marrow function

Clinical monograph

How it works

Chloramphenicol inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, giving a broad-spectrum bacteriostatic effect.

Prescribing in practice

Hypersensitivity reactions to the drops or their excipients can occur, and the product should be avoided in those with a history of chloramphenicol hypersensitivity.
Aural toilet to clear debris improves drug contact with the canal in otitis externa.
Treatment courses are kept short to limit local sensitisation and resistance.

Monitoring

Review the ear clinically for response and watch for local hypersensitivity during treatment.

Counselling the patient

Use only in the affected ear as prescribed.
Stop and seek advice if itching, rash or swelling develops.
Complete the prescribed course and keep the ear dry.

Evidence & guidelines

Topical antibiotics are an established treatment for bacterial otitis externa in UK clinical guidance.

Reference: NICE CKS Otitis Externa; ENT-UK Guidelines for Otitis Externa; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways