by Neil Bauman, Ph.D.
December 21, 2007, Revised January 29, 2015
A lady explained,
I have an ear infection, tinnitus, and a history of hearing loss in my family. My MD has prescribed a medication that I can not find any information about, ‘Augmomyn’. He says it is a “type of Amoxicillin”. Do you have any information about that? I could not find it in Ototoxic Drugs Exposed, or in searching the Internet.
I’m not surprised you can’t find a reference to “Augmomyn” since the name of this drug is actually Augmentin. Trying to interpret the doctor’s hieroglyphics is a bit of a challenge, isn’t it?
Augmentin is actually a combination of two drugs—Amoxicillin and Clavulanate potassium.
The reason Augmentin is not listed in my drug book (3rd edition) is that it is not known to be ototoxic. It is actually one of the very few antibiotics of which I know that is not reported to be ototoxic.
__________________
January 29, 2015 Update: I wrote the above back in December, 2007. Up to that point, I had not found any reference that indicated that Amoxicillin was ototoxic. Since then, I have learned otherwise. Here’s what I now know about Amoxicillin ototoxicity. The following information will be included in the 4th edition of my drug book whenever in comes out–probably in a couple of years.
Amoxicillin has been reported to cause hearing loss in a few people, and tinnitus in a number of people. In addition, and more commonly, numbers of people end up with dizziness, vertigo and vestibular disorders from taking Amoxicillin. Here are some anecdotal reports I have received on this drug.
A man got mild tinnitus when he took Augmentin for pneumonia.
A lady reported, “I just took Augmentin and the volume of my tinnitus went up. I don’t think I can bear this level of tinnitus.”
A man’s tinnitus went from a 2 (out of 10) to an 8 after he took a course of Augmentin for his sinusitis.
A lady reported, “I took a course of Augmentin Duo Forte tablets and have had severe tinnitus since day two of taking the medication.”
A man explained, “My doctor recently prescribed Augmentin for sinusitis, and I took a complete course. Result: loss of hearing in both ears, with volume and clarity diminished significantly across all frequency ranges, but especially in the highs. I now have to cup my ears to hear clearly what people are saying. The loss set in motion is progressive, in other words its getting worse from day to day, even though I ceased the course a week ago.”
A lady wrote, “I was prescribed 1g (as against 625 mg) dose of Augmentin for a persistent typhoid infection. On the last day of the two-week regime, I lost 80% hearing in my left ear as well as developed tinnitus. I went to three separate ENT specialists, where I was told it was not the Augmentin when I was pretty sure that my hearing was perfect before taking the drug. Its been almost 2 years since then and my hearing has not come back, but the ringing is still there in my left ear.”
As you can see, Amoxicillin really is ototoxic to some degree. Disregard anything I have previously written to the contrary. The same holds true for Acetaminophen. It is now also known to be ototoxic, contrary to what I have written about it in the past. Sometimes a lot of years pass before the ototoxic side effects of a drug finally come to light. For example, Erythromycin first appeared on the market in 1952, and doctors prescribed it for 20 years before someone put 2 and 2 together and realized, “Hey, this drug is ototoxic”. In the case of Vicodin, it took 21 years. In the case of Acetaminophen, it took an incredible 117 years!.
I recently and most unfortunately have learned about ototoxic drugs. In December 09, I was prescribed Levaquin for an Urinary Tract Infection. Levaquin destroyed all the cillia in my cochlea and I have suffered from hyperacusis and unbearable tinnitus ever since. It has taken away the joy of the sounds of life from me. I suffer sever anxiety and depression from it also. It has ruined my life. Dr. Bauman if you have any advice, please submit to my e-mail address. Thank you
Does Benadryl have ototoxic effects? I have been taking it for years as a sleeping aid and recently read some bad news about it. I am not going to be taking it anymore but I am very curious if it is ototoxic since I had been taking it for almost a decade. Thank you, Florence
Hi Florence:
Yes, Benadryl can be ototoxic. I have it listed as causing tinnitus, ataxia, dizziness, labyrinthitis and vertigo in some people. I’ve never seen it linked to hearing loss though.
If you’ve not been experiencing any of the above side effects over the years, then Benadryl is not likely negatively affecting your ears.
Regards
Neil
Hi Dr. Neil,
I did stop taking Benadryl last year and have had sleeping problems ever since. I do have Hyperacusis and Tinnitus from Levaquin that I had to take for a UTI in December’09. It has been terribly awful to cope with. I have soundgenerators for my ears that will hopefully help me with the h&t in the future.
Unfortunately, I have just gotten another UTI. I am petrified to take an antibiotic, even one listed safe such as Augmentin. Women my age are prone to UTI’s due to a decrease of estrogen levels. I am anticipating future infections since I am just approching menopause. Could I sustain further damage to my ears from Augmentin or another antibiotic?
Thank you for your help and support.
Florence
I cure my UTI naturally with D-Mannose and echinacea and goldenseal.
Hi Florence:
As I said in my article above, Augmentin isn’t known to be ototoxic so you shouldn’t have any ear problems from taking it.
With other antibiotics all bets are off. Almost all of them can be ototoxic, some more than others. The trick is to find one that does the job and yet does not damage your ears.
If you send me a list of the possible antibiotics your doctor thinks will do the job, I can list them in order of ototoxicity for you. Then start with the least ototoxic one and see if it works but does not damage your ears.
Regards
Neil
I am an RN and my close friend has sudden total hearing loss in the left ear . He has had chronic sign you situs with multiple courses of anabiotic’s and OTC is to manage . I’m trying to come up with a comprehensive list of ototoxic medications he should avoid . ENT has completed the steroid injections, everything possible is being done . He had chronic ibuprofen use, sometimes higher doses. I understand it it depends on the situation, but would like to know how to evaluate each med risk
Hi Mary:
What do you call sudden? Within 5 minutes, or overnight? or over a period of two weeks? or what?
Also, what do you call total hearing loss. To me that would be hearing loss of at least 120 dB at all frequencies. Almost no one has that kind of sudden hearing loss.
Since the vast majority of drugs out there are ototoxic, it’s hard to come up with a meaningful list. My book, “Ototoxic Drugs Exposed” is probably the most comprehensive collection of such data readily available.
Why is your friend taking all these drugs since they are obviously not doing the job, but are causing other side effects? All antibiotics can be ototoxic. And Ibuprofen is quite ototoxic–especially if you take it in high doses or for long periods of time.
It’s so hard to evaluate each drug for ototoxicity because not all the information you need is available in one place, and often it is just plain not available. That is why I have compiled all the information I come across into one place. No one knows better than me just how woefully inadequate this information is–but still it is the best information available.
Cordially,
Neil
Hi Dr. Neil,
I have been on Augmentin twice so far to get rid of a recurring UTI since my last letter. Unfortunately, it doesn’t seem to be clearing up the infection this second time either. I will be getting another urinalysis in 2 weeks and if necessary I’ll be grateful for your advice on antibiotics. My acupuncurists told me there is a Chinese Herb that gets rid of UTI’s but I’m not sure if I would trust it’s effectiveness. Have you had any experience with that type of medicine and would that be a good alternative to antibiotics?
Thank you again for your help.
Florence
Dr. Neil,
One more question if you would be so kind. Could you give me the list of the least ototoxic antibiotics that you are aware of? I will be calling my doctor tomorrow and let her know I am still having UTI symptoms and it would be so helpful if I knew which antibiotics would be ok for me to take besides Augmentin.
Thank you so much
Sincerely,
Florence
Hi Florence:
I’ve not heard of this Chinese cure–but I have no reason to doubt its effectiveness. I’d sure think it is worth while giving it a try if the Augmentin isn’t working. At least it won’t be ototoxic.
As far as making a list of the least ototoxic antibiotics, that is the backwards way of going about it. You see, I don’t even know what class of antibiotics might be effective against your UTI.
It’s lways better to ask your doctor for a list of those specific drugs he thinks will work on this infection. THEN I can put them in order by their degree of ototoxicity.
Regards
Neil
Hi Dr Neil,
My mother has the poly cystic disease of the kidney and has been having recurrent kidney infections/Sepsis since Feb this year. She was put on Levoflox. Augmentin and Clarithomycin in July. Her infection has improved considerably since then but off late I have observed that she is having a slight hearing loss. Can you please confirm if any of the antibiotics mentioned above (other than Augmentin) can be ototoxic?
I see that you’ve said that Augmentin is not ototoxic. However, I just took a pill amd the volume of my tinnitus went up. Should I just grin and bear it and expect it to go down again? I don’t think I can bear this level of tinnitus. Please respond to my email address, and this site if you wish to. Thank you so much for your help.
Is it that Augmentin is not KNOWN to be ototoxic or has it been proven so? I was on Augmentin in Jan and subsequently lost partial hearing in my R ear. Not thinking any correlation, I went on it again2 weeks ago and now am confirmed 100% deaf in R ear. Coincidental? So scared.
Hi Dr Bauman.
Just letting you know that I took a course of Augmentin Duo Forte tablets in April 2014 and have had severe tinnitus since day two of taking the medication. The medication is clearly ototoxic, at least for some individuals and I appear to be one of them.
I am most disappointed that the drug company has not been at all up front about the side effects of this medication. I have lost the high range of my hearing and miss being able to hear the night sounds of our tiny local frogs and crickets, among many other things. I had to get used to the sounds around my house as there are clearly frequencies missing now in my hearing range. The tinnitus moves from the foreground to background of my hearing but never goes away.
Most upsetting. It was definitely this medication that caused the problem.
Hi Sue-Ellen:
You say you have lost your high-frequency hearing. Are you saying the Augmentin caused this? Or did you have this hearing loss before taking it? I have no information indicating that Augmentin causes hearing loss, but for a few people it does cause tinnitus or tinnitus to get worse.
Regards
Neil
I have never had any hearing problem until a month ado when I took augmentin for a sinus infection. I noticed tinnitus had begun and it has never ceased since, 24 *7. It clearly cased my hearing loss and tinnitus
I also too 875 mg twice a day for 5 days, for sinus infection
I now have tinnitus
My ears don’t drain either. If i blow my nose, water comes through my tear ducts
Hi Rachel:
Hundreds of people have reported to the FDA of getting tinnitus after taking Amoxicillin (Augmentin). Looks like you may be one of the “lucky” ones who have had this happen. You could also have tinnitus as a result of your ears being clogged and thus reducing your hearing somewhat. If this is the case, when your congestion clears and hearing returns to normal, your tinnitus should disappear.
Cordially,
Neil
Hi Neil,
Sadly, I have to confirm what two of your correspondents have experienced, namely the ototoxicity of AUGMENTIN. I thought it was safe because not mentioned in your book, but my doctor recently prescribed it for sinusitis, and I took a complete course. Result: loss of hearing in both ears, with volume and clarity diminished significantly across all frequency ranges, but especially in the high. I now have to cup my hears to hear clearly what people are saying. The loss set in motion is progressive, in other words its getting worse from day to day, even though I ceased the course a week ago. Just let my guard down once, and my hearing is on the way out. It might be the addition of the Potassium Clavulanate that provides the synergistic killer stroke (I don’t know why its added or what it does to disable bacteria), since I recall taking straight amoxicillin some years ago for a dental procedure without any ill effects. kind regards Paul
I also experienced the onset of tinnitus the day after starting amox/clav in April 2014. My ENT confirmed loss of hearing in my left ear only (everything above 1 kHz is attenuated. Six months later (October 2014)and I still have the ringing and hearing loss in that ear. Very depressing.
Hi. I have been looking for information on Augmentin’s ototoxic effect since 2012, and I just got to see that I am not alone.
in July 2012, I was prescribed 1g (as against 625mg) dose of Augmentin for a persistent typhoid infection. on the last day of the two-week regime, I lost 80% hearing in my left ear as well as developed Tinnitus.
I went to three separate ENT specialists, who did tests, prescribed steroids and hearing aids. I was told it was not the Augmentin when I was pretty sure that my hearing was perfect before taking the drug.
Its been almost 2years since then and my hearing has not come back. I ve taken myself off the steroids and since learnt to adapt to my condition, listening with my right ear and ignoring the ringing in my left.
I think more research should be done on the ototoxic effects of Augmentin, and I would appreciate any advice on what to do to regain my left hearing or at least stop the ringing.
thank you.
I have a 6 year old granddaughter , that has just been told that she is going to have to wear hearing aides in both ears. She had C-def. when she was 12 months old and countless different sicknesses since then . And she did have Augmentin during this time.
Good day Dr Bauman. I have a middle ear infection, what is the least ototoxic/safest antibiotic that I could take? Is it wise to not take antibiotics and only take it if the infection doesn’t go away after a month or two?
Hello recently I was given Augmentin for a sinus infection. I’m now nearly deaf in my right ear. My left ear is clogged and I have sensory issues. I will probably be getting hearing aids if this mega round of Prednisone doesn’t help. I did not even take Augmentin for a full week before I notice a problem so I stopped it. People need to be informed about this issue.
I just took a 14 day course of Augmentin for Diverticulitis, and last night my right ear just started to have a strange sensation of being stopped up. I was sitting on my bed and I stood up, and it felt like the deep inside of my ear was vibrating (a low dull sound, with a throbbing). I have never had a problem with my hearing or any kind of infection inside my ears, so I came online to look up the side effects of Augmentin, and found this site. I hope this ear problem will go away, but after reading other peoples experience I am worried. I will keep you posted if it goes away.
Did it go away? I have the same thing happening now. It is driving me crazy!!
Two weeks ago, I took augementin 1000 twice a day for angina and there were no problem on my ears,one morning when i woke up I heared very strange noice and i did not mind and it removed in the day but the day after in the morning i felt the same strange noise ant it continued . I feel very bad now,
I got tinnitus in my left ear after exposed to extreme loud noise at work only 11 hours/1 day, been 5 months now and i stil have tinnitus , the left ear ringing is low i hear it when i lying down on bed in the bedroom , and i hardly hear the ringing outside the house.
I can hear with my left ear but i think it is weaker than the right ear.
i have Gingivitis now and the doctor prescribed me “Augmentin” , does that increase the ringing in my ear ? it is safe ?
i took Augmentin 2 years ago but i did not have tinnitus or ear problems back then
Hi Adam:
Augmentin can indeed cause tinnitus or make it worse, at least in some people. And it can also cause hearing loss. Thus you want to be cautious in taking this drug.
However, you took it before without any side effects, so it is likely that you can do so again without problems. However, there are no guarantees you won’t get any side effects now, especially since your ear is already “damaged”.
You need to take some antibiotic, and since all are ototoxic as far as I know, you need to opt for one low in reported ototoxicity, and Augmentin is one such drug. There is risk–yes–but there is risk in taking nothing too.
You’ll have to weigh the pros and cons and make a decision you are willing to live with.
Cordially,
Neil
I wish you had updated your list of ototoxic drugs to include Amoxicillin. It would have saved me a lot of pain.
I developed tinnitus about 20 years ago when treated for walking pneumonia with massive antibiotic doses. It was never bad until the last couple of years when I was treated with Levaquin and then Flagyl for a couple of infections. Last year I thought my tinnitus couldn’t get worse after the treatment for diverticulitus in the er but boy was I wrong.
I developed a case of chronic sinusitus that just wouldn’t go away. I finally went the an ent who wanted to prescribe an antibiotic. Being very hesitant to get on an antibiotic (scared, your might say) I did a some research and checked your list. Penicillin continually came up as the only antibiotic that was not ototoxic and it was not on your list. Long story short, after 2 days on Amoxicillin, I discontinued the treatment and my tinnitus is now unbearable, although I don’t have a choice but to deal with it. It was pretty bad before but now I don’t know what I’m going to do. I haven’t been back to have my ears checked but I’m pretty sure I’ve got some loss.
The broader issue, of course, is what am I going to do if/when I need surgery or have some other condition that requires an antibiotic.
I went on Cipro for UTI and my tinnitus spiked about a day after starting it. I stopped taking it and was then switched to Augmentin. There was a spike in my tinnitus just 1 hour after taking the first dose. I need some sort of antiobiotic for my UTI but now am afraid to take anything for it. Any alternatives?
Hi LP:
As you have found out by experience, both Cipro and Augmentin can cause tinnitus or existing tinnitus to get worse.
There are always alternatives. Ask your doctor what other classes of drugs would do the trick. For example, if some of the cephalosporin class of drugs would work, I could tell you the least ototoxic drugs in that class.
I don’t know which drugs would work for you so I can’t suggest any drugs–that’s your doctor’s job. But if he gives you a list, I can tell you which is the least ototoxic and least likely to cause your tinnitus to flare up.
Cordially,
Neil
Thanks for the quick reply! I had 2 other questions…
1) I was wondering if you thought Prednisone helped with reversing early onset of T from antibiotics? My doctor gave me 40mg to start with a 10 day taper but I’m also reading that it makes some peoples’ T worse. Any ideas?
Also, I have a small open blister and put on some neomycin antiobiotic not realizing how bad it was and then immediately washed it off when I came across it on here. The blister is only the size of a pea. I put on about a gram of the ointment (3.5 mg neomycin per gram) and am wondering how much my body could have absorbed in the short time it was on and how damaging it can be in this small amount?
Thank you again!!
Hi LP:
I have not heard that Prednisone helps with reversing tinnitus from any cause. IF the drugs caused both hearing loss and tinnitus, then if it helped bring back the hearing, that could reverse the tinnitus. But for just tinnitus from taking drugs, I have no information that it works, and there are ALWAYS side effects from taking drugs. Thus, my thinking is that since there is no good evidence that it will help and there is lots of evidence of negative side effects, I think the balance is in favor of not taking this drug.
Why put any antibiotic on an open blister. If your immune system is working properly, it will take care if it without treating it with antibiotics. That is what I’ve done for decades.
Personally, I doubt that the Neomycin will cause you any problem since it was on for such a short time. I’m assuming the blister was on a hand or foot and not right up by your ear.
Cordially,
Neil
Yes, the blister was on my ankle about as far away from ears as could possible be.
Thank you again for your taking the time to answer questions. You’re a huge help to all T sufferers!
Thanks so much for the great site and posts.
Over the last year I developed hearing loss in both L an R sides. Left side more severely. Did 20 hyperbaric sessions and recovered th R side loss and stabilized L which has most high freq loss.
That was 10 months ago. Now I have a epididymis issue for which my test shows E. coli. I’m a 52 year old male. I tried Bactrim with no success but no hearing issues either.
They now want to try Cipro or Doxycline both of which are ototoxic.
Researching other antibiotics for this condition am hoping you can let me know from the following which are the least ototoxic:
1. Amoxicillin
2. Nitro duration
3. Fosfomycin
4. Cefaclur
5. Cephalosporins
Again, thank you very much for the great work and information!
Hi Dave:
Of the two–Ciprofloxacin or Doxycycline, I’d choose Doxycycline. I had a somewhat similar problem recently and those were the two drugs my doctor also suggested. I said categorically “No” to the Cipro, but chanced the Doxycycline. Fortunately, I had no negative ototoxic side effects from the Doxycycline.
Of the 4 other drugs you list, Amoxicillin is the most ototoxic. The other three–Nitrofurantoin, Fosfomycin and Cefaclor are all class 1 drugs–they are not listed as causing either hearing loss or tinnitus–so they would be my first choice if they would work. (I was told that Nitrofurantoin wouldn’t work in my case. You may find the same.)
Cefaclor is one of the Cephalosporins. As a class they are not all that ototoxic, but there is still variation within that class. The least ototoxic ones include Cefadroxil, Cefaclor and Cefazolin. The most ototoxic in this class are Cephalexin and Cefuroxime.
So if they would do the job, just from an ototoxic point of view I’d go for the Nitrofurantoin, Fosfomycin or one of the 3 above mentioned Cephalosporins. Your choice.
Cordially,
Neil
Thank you so much for the very thoughtful and detailed response. I’m going to discuss those options with the urology doctor tomorrow. Glad to hear (pun intended) doxycycline worked well for you.
Hello Dr. Neil,
I had my check up this afternoon about my hearing loss problem, particularly RE. She suggest to take med, augmentin 625 mg tablet and Claricort 5mg tablet. Yes, Im happy since finally I have doctors prescription about my hearing losa problem but Im upset when she said “this is just a trial for 10 days, then if not effective lets try other med..” Upon reading your blog, I can say I am more doubt about her prescription.. Pls advise me. Thank you.
Hi Jodji:
What is your question? What are you taking the drugs for? I can’t help you if you don’t tell me your story.
Cordially,
Neil
Hi DR,
Can you please show or state what evidence you have that Amoxicillen is toxic to the inner ear. I have read through the forum and from your original most you refer back to another antibiotic or another name. Not amoxicillin. I have been suffering from a vestibular disorder now consistently for 3.5 months. And for some reason I have had a significant set back. This is affecting my day to day life from preventing me from working and most times leaving the house. I have had a sinus issue throughout this ordeal and have been prevribed amox as it won’t clear. I am reluctant to take anything that may cause any damage to my inner ear when I am already suffering so bad. But then I can only wonder if the issue I have is not dissapearing due to the sinus problem. Any advice and help would be much appreciated. Thank you.
Hi Emilia:
That article I wrote tells of numbers of people that experienced ototoxic side effects from taking Amoxicillin. Since I wrote that, I’ve received more such reports.
One of the brand names of Amoxicillin is Augmentin. Another is Amoxil.
Amoxicillin causes balance problems too. Numbers of people suffer from dizziness and vertigo related to taking Amoxicillin.
It’s hard to know whether the sinus problems are causing your ear problems, or the drugs you have used to try to treat the sinus problems are the real culprits.
What is causing your sinus problems–allergies? cold virus? or what?
Cordially,
Neil
Hi Dr. Thank you for your reply. I don’t know what is causing my sinus problems. Every morning I wake up to one side “blocked” but it feels like more of an inflammation rather then congestion. I have had this issue for the last 4 months and it fluctuates in how good or bad it is. It stated alongside my illness which I am awaiting a diagnosis for but I believe it is vestibular neuritis. Again I have no idea where it came from. I just woke up. I did take an anti b for 4 days prior to this starting called metronidazole. Supposidly it can’t have caused this but I’m not sure. Currently doing VRT exercises in the hope that my brain will compensate but my sinuses are causing me a pain too and I can’t help but wonder if they are linked to my delayed and slow recovery. I can’t blow anything out of them. It feels as though I have a post nasal drip down my throat. I have tried the sprays with steroid given by dr and they have they prescribed amoxicillin. I have been on them many times in the past probably too much. And have been absolutely fine. But since I have had this illness I have of course done a lot of research and have learnt that some anti biotics can be toxic to the ear therefore I am reluctant to take them but I am also concerned about not taking them. I’m at my wits end. I’m terrified to be honest. This vestibular problem I have had ruined my life and I am hoping I will make a full recovery but as I say I can’t seem to shift the sinus issue. My sinuses click and crackle every morning and hey do if I breath in deeply through my nose. I have bad tooth aches too now and pressure headache slightly. Just want some relief. I wish so much that anti biotics were safe to use so they could possibly clear this. I have spoken to a few people in a vestibular support group I’m in and they have taken amoxicillin during this illness and been fine but knowing me and my luck I would be the unfortunate one and I just can’t risk it. How dangerous is amoxicillen. Are the ingredients the same. I live in the U.K.
Thank you. Emilia.
My email is milly-kate@hotmail.co.uk
If you want to email me too.
Any help would be much apparexiydd.
Hi Emilia:
Before this started, was there any changes that you made in your life, or even in your bedroom? For example did you get new bedding, or a new mattress, or new pillow? I’m wondering if you are allergic, or are reacting to some of the chemicals they use in such things, and that is the cause of all of your problems.
Sometimes you have to look at things that don’t seem to be related, but are fundamentally the cause of your problems. You see, if you only have this problem when you lay down at night, or more correctly, when you wake up in the morning you find you have sinus problems, then it could be related to your bed or bedding materials.
Do you have exactly the same experience if you are not at your home? If you stayed at a friend’s place or in a hotel, or even sleep in a different bedroom in your house, do you have exactly the same results are not?
Do your sinuses clear in the next hour or so once you get up? Or does this sinus problem persist all the time during the day?
Metronidazole can cause a number of ototoxic side effects such as hearing loss, tinnitus, ataxia,, dizziness,, nystagmus and vertigo in some people.
Most people taking Amoxicillin, and report to me about their side effects, mostly complain of either hearing loss or tinnitus.
Cordially,
Neil
No no changes at all. Not that I’m aware of. This vestibular disorder has come out of nowhere. Supposedly triggered by a virus but no one really knows. I believe stress and a virus played a part. No new bedding. My pillows were changed a few months back before this started. My vestibular illness is constant. Always. Never have a break from it. But the sinus issue is worse in the morning. I have started using a salt spray but it’s not really clearing the clicking sensation in my sinuses. My ears seem like they have a fluttering noise in today. They itch and open and close. Crackle. I assume connected to my sinuses. But again who knows. I haven’t actually slept out recently but I spent time at my sisters during this and still woke up with the same issues in my sinuses. As soon as I’m stood up I hear them crackle and de “congest” as such. They feel inflamed rather than blocked.
The side effects to metronidazole. Can they be pennant so do the side effects continue after use? Can they damage the inner ear. And can it happen in small doses or could it happen in a short space or time. Have you had many people contact you in regards to this medication? Any damage that has been done is it permanent? Can it be recovered. So most that take amoxicillin complain of side effects? Are these side effects permanant? Did the people complaining of tinnitus or hearing loss have issues prior. And can I ask that this amoxicillin people have mentioned is this amoxicillin or is this augmentin mixed so the other ingredient with amoxicillin.
Thank you. Look forward to your reply.
Emilia
Hi Emilia:
Stress and the virus could well play a part. You see, stress reduces the vitality of your immune system. When your immune system is compromised, any virus or bug that you have in your body at that time can much easier gain the ascendancy. You know your own body better than anyone else and if you believe that stress and a virus caused this condition, I see no reason to disagree with you.
I don’t have a lot of information on Metronidazole, but the information that I do have seems to indicate that after stopping this drug hearing loss resulting from this drug returns in somewhere between two and six weeks. Since this appears to be true for hearing loss, it is probably also true for the other ototoxic side effects this drug causes.
I have no information on how small a dose results in ototoxic side effects. since everyone is different, you could expect that the dose required to produce ototoxic side effects varies from person to person.
You misunderstood about Amoxicillin. I said that most of the people that contact me about side effects from taking Amoxicillin complain of tinnitus and hearing loss, not that most people that take Amoxicillin get ototoxic side effects.
In numbers of cases,, the side effects are permanent. In others, not enough time has gone by to know whether it will be permanent or not. But I tend to think that tinnitus and hearing loss tend to be permanent.
As far as I know the people complaining of tinnitus or hearing loss did not have prior issues. They attribute all their ear problems to taking the Amoxicillin.
Some people took Amoxicillin and others took Amoxicillin/Clavulanate. Typically they don’t tell me exactly which drug they took. Most of them just say they took Augmentin.
Cordially,
Neil
I am on day 4 of Augmentin 875mg for bacterial Actinomyces.
I have previous low level tinnitus in my right ear.
Today, with the Augmentin, I’ve had acute onset of loud tinnitus in my left ear, that comes and goes in waves.
Based on your comments, I’m going to get a hearing check to monitor this tinnitus before and after, as the course of Augmentin is for 60 days.
Just info to add to your research. Thx
I developed bilateral vestibular hypofunction in march of this year. It was discovered after treatment for BPPV. I was on nitrofurantoin for a bladder infection at the same time. I had used it in the past for a bladder infection without a problem. I’m told it’s unlikely it caused my BVH. I’m told it is idiopathic. However I am now terrified of all meds. I was also on spironolactone Wellbutrin and synthroid at the time and am also told none of them did it. I use to take Benadryl at night for sleepoften I’m currently weaning off Wellbutrin as I have read it is a 4 in your book. I will try meditation deep breathing instead. I guess I’m asking if I caused this to myself with any of the medications I had taken. Is macrobid ok?
Hi Lisa:
Hundreds of people have reported balance problems as a result of taking Nitrofurantoin. Since you have used it before without problems, perhaps it didn’t bother your ears this time either–but it could have.
Spironolactone is more ototoxic. Thousands of people have reported having balance issues after taking this drug, so it is a likely culprit.
Even more thousands of people have reported balance issues after taking Wellbutrin. It is another likely culprit.
As far as I know, synthroid is off the hook.
Benadryl has also resulted in thousands of balance problems being reported to the FDA so it could also be the culprit.
And no one knows how the combination of these drugs might have affected your balance.
Personally, I think the drugs you took did damage your balance system.
MacroBID is a brand name of the generic drug Nitrofurantoin (see above).
Cordially,
Neil
Dear Dr. Neil,
I actually woke up one morning and my hearing was partially GONE Went immediately to my ENT and he said if was probably caused by the Clindamycin he had me on for a sinus infection. I asked if it would be permanent, and he said probably. Went to Audiologist and got hearing aids, which helped. But my doctor was right. My hearing did not come back and it was complicated by me having Tinnitus. This was several years ago and recently I was given Clindamycin for a tooth problem. I explained that I had taken it before and experienced hearing loss. He told me this was the best drug for my problem and that my hearing loss was not connected to the drug I was taking at the time, Clindamycin. I took it reluctantly, a 10 day course. About 2-3 days after finishing it, I woke up with the hearing in my left ear gone. Went immediately to my ENT, another doctor that I am currently seeing and he was doubtful that my medication had caused the additional hearing loss. But I’m convinced that I know my body better than he does, and I don’t think it’s coincidental that it’s happened twice. He has me on Methylprednisolone a 5 day treatment to try to recover my additional hearing loss. So I’m convinced you can add Clindamycin to your list of meds. I would appreciate your feelings on my problem. Thank you.
Hi Ann:
I’m with you. Clindamycin (one of the Lincomycin class of drugs) is indeed ototoxic. You are not alone in getting hearing loss from taking this drug. The FDA database contains hundreds and hundreds of reports of people getting hearing loss from taking Clindamycin.
Now that you know that you are very sensitive to Clindamycin ototoxicity, refuse to take this drug in the future unless it’s a matter of life and death or you risk losing the hearing in your other ear.
Cordially,
Neil
Dear Dr Bauman,
I have suffered from tinnitus caused by Aspring for the lats 15 years. It was made worse after using NSAIDs (I now only take paracetamol, which doesn’t affect my tinnitus).
I have now (being a 46 year old male) been diagnosed with a mild pneumonia and my GP has prescribed Amoxicillin (sold under this name in France, where I live), which I took. I’ve actually taken three times (1 gm three times a day) and can now feel some sort of dizziness and I think a slighly louder tinnitus. Do you know what other antibiotic I should take, if any?
I look forward to seeing the fourth edition of your invaluable guide to ototoxic drugs published.
Best regards,
Pierre.
Hi Pierre:
Amoxicillin is the most ototoxic drug in the Penicillin class of drugs. Less ototoxic choices would be Piperacillin/Tazobactam, Benzylpenicillin or Ampicillin. They can all cause tinnitus, but the risk of getting tinnitus is much lower than for Amoxicillin based on the number of reports received by he FDA.
You’ll have to talk to your doctor and see if these drugs will do the job or not.
You’ll also have to ask your doctor if any othe classes of antibiotics would also do the job, if you want to try a different class of drugs. I can then tell you the least ototoxic in that class and how it compares to Amoxicillin.
Cordially,
Neil
You can add me to the list of Augmentin users that have acquired partial hearing loss and tinnitus. I also have this pulsating pressure sensation in my ears. I can can hear the tone of the tinnitus change as the pressure fluctuates.
No reply necessary, I just wanted to add my name to the unfortunate growing list of people that have been effected by this drug. Take with great caution
Dear Dr Bauman,
My dear 4 year old daughter took Augmentin to treat ear infection about half year ago, but she had pretty bad allergic reaction, a lot of hives on her back and butt. We stopped using the Augmentin after twice of usage. Couple of weeks ago, she didn’t pass the hearing test, and diagnosed with mild hearing loss of the right ear, the left ear is normal so far. We strongly suspected the Augmentin allengic reaction caused her hearing loss.
Hi Peter:
You could well be right. Hundreds and hundreds of people have reported to the FDA that taking Amoxicillin (Augmentin) resulted in their having hearing loss.
Cordially,
Neil
Augmentin is not Amoxicillin. I have taken both in the past. Augmentin is Amox/K Clav and Amox is just Amoxicillin. Are both ototoxic or just the one with K Clav added? I can’t take that one because of stomach problems. I need an antibiotic for a sinus infection. I have no hearing loss or tinnitus so I don’t want to risk something permanent.
Hi Krista:
Augmentin is a combination drug and ALWAYS contains Amoxicillin plus in this case, Clavanulate (Clavulanic acid). As far as I know Clavanulate is not ototoxic, but anything that contains Amoxicillin is ototoxic.
I don’t know of any prescription antibiotics that are not ototoxic to some degree. Thus, you have to choose an antibiotic that is the least ototoxic. If it is in the Penicillin class of drugs, the least ototoxic (as far as I know at this point) would be Bacampicillin followed by Piperacillin and Benzylpenicillin.
Cordially,
Neil
I took a high dose regimen of Augmentin for diverticulitis and strep and now have persistent ringing in my ears. I am 33 yrs old and had perfect hearing beforehand. I stopped the antibiotics after a week after I noticed the ringing but I guess it was already too late. It’s been almost 4 months and no change. Thank you for raising awareness to this issue as almost no one knows about it. I am so depressed thinking this may be for the rest of my life with no known cure for tinnitus.
Hi Ty:
You have the wrong attitude and taking this attitude will leave you depressed for the rest of your life. Much better to focus on the loves of your life and let your tinnitus fade into the background.
You’ve only had tinnitus for 4 months. I’ve had tinnitus for more than 70 years and I’m still excited about living. I don’t let my tinnitus bother me and take away my love of living. You don’t have to be depressed. You can learn how to habituate to your tinnitus so it is no longer an issue. There are many different things you can do to deal with your tinnitus. I discuss many of them in my book, “Take Control of Your Tinnitus”. I suggest you get it and read it, and then move forward. You can get it at https://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/
You’ve learned an important lesson, drugs can damage your ears no matter what the doctors, etc. say, so you need to be careful when taking them in the future.
Now, you can’t go back and change things, but you can choose what you are going to do in the future, so embrace life and let the depression fade away as you follow the principles of successfully dealing with your tinnitus.
Cordially,
Neil
what antibiotics are ok to take which are to ototoxic
Hi Frances:
ALL antibiotics are ototoxic to some degree or other, so you have to choose the least ototoxic one that will do the job. Ask your doctor what classes of drugs will do the job and I can suggest the least ototoxic drugs in that class.
Cordially,
Neil
Hi Brent. I too took Augmentin and now suffer from severe tinnitus and hyperacusus. It’s been 3 days since I stopped and its getting worse. Did you ever get better?
My 6 year old has tinnitus. He’s had it about one year. He just started Amoxicillin for strep and had a terrible increase in tinntus volume. Do you have any recommendations for strep throat alternatives to amoxicillin?
Hi Erin:
Ask your doctor which other antibiotics could do the job. Then I can tell you which of them is the least likely to worsen his tinnitus. I’m not a medical doctor so don’t know which drugs are effective against strep throat, but I can tell you how ototoxic they are (in my opinion).
Cordially,
Neil
Dear doctor,
I have tinnitus for 5 months after a grommet was placed in my ear. The tinnitus is getting less but it is not gone.
I have now a horrible sinus infection and I got a prescription for Augumentin Retard 2 pills twice a day together with 5 mg prednisone for 7 days.
Could this increase my tinnitus? I’m quiet scare to take the medecine.
If I get a spike would that be temporary?
Hi Nathaly:
All antibiotics can cause tinnitus–some are just worse than others. So the trick is to find the least ototoxic antibiotic that will do the job. Hundreds of people have reported to the FDA here that taking Amoxicillin caused their tinnitus.
Furthermore, I have received numbers of anecdotal reports that seem to indicate the resulting tinnitus may be permanent. So you take your chances with this drug.
Cordially,
Neil
Hello, I am trying to figure out what is going on with me from any place I can.
Started in December 2018 three weeks after having root canal on right side. I was having augmentin and Brufen for 10 days during root canal procedure.
Root canal was simple and did not have any complications. I was perfectly fine for three weeks. However same day the dentist informed me I have impacted wisdom tooth right side with a very huge cavity black in color horizontally displaced towards the ear but above the jaw bone. I ignored the wisdom tooth. I mentioned to doctor that I have TMJ and clicking in the right side, he said mostly because of the wisdom tooth and only matter of time to take it out.I said I will come back for wisdom tooth.
Immediately after root canal I traveled to turkey (like three days after root canal). It was extremely cold and I did not cover my neck, ear or nose.
On return right before hearing loss, I experienced sore throat and feverish and like i was having a cold and flu but no nose discharge or sneezing.
three weeks after root canal, upon plugged ear feeling and decreased volume of hearing I went to emergency and referred me to ENT (Dec 2018). ENT did physical said no infection present. No tinnitus at this time. Did hearing test and showed conductive hearing loss of low frequency upto 50 DBhl and high frequency up to 20 DBHl. Tympanogram test was normal both peaks at zero. I went home dejected. Tuning fork test revealed higher sound on defective ear suggesting conductive loss
Dec 2018 : Visit second ENT – totally useless he suggested I may sinusitis and sent me home with advise to steam. Did tympanogram – which came at normal both peaks at zero and hearing test low frequency at 40dbhl and high frequency at 15dbhl. Tuning fork test revealed higher sound on defective ear suggesting conductive loss
Dec 2018 : Went to another ENT surgeon – He diagnosed me with Sinusitis and provided me with mutivitamin, and nasal spray and anti histamine. He said come back after two weeks as he could see fluid in the ear. this doctor seemed to know what he was talking about. Tuning fork test revealed higher sound on defective ear suggesting conductive loss. Hearing test showed low frequency at 30DBhl and high frequency at 10 DBhl
Jan 2019 : Retuned to ENT 3 did hearing test showed improvement in hearing audiometry low frequency at 30 DBHl and high frequency at 10 DBhl. However tinnitus became worse. At this time my eustacian tube on the right was extremely stuffy and sticky. When I burp I get no pressure to my right ear from inside. However ENT performed typanogram the peak levels showed normal at zero. He was very confused. He provided more antihistamine, and nasal steroids to open up the eustacian tubes. Tuning fork test still reveals higher sound on defective ear suggesting conductive loss. developed gastritis and acid reflux which I ignored as I was focusing on my hearing
Feb 2019 : returned to ENT 3 and did hearing test again, same hearing as Jan 2019 no improvement. He said relax wait it out and provided nasal spray for 1 month. Tuning fork test revealed higher sound on defective ear suggesting conductive loss. Developed gastritis and acid reflux. Burping provides no pressure on right side. Did CT scan – CT clear for sinuses. Other unrelated issues I had one EYE infection and one episode of gout both cleared.
March 2019 : returned to ENT 3 and did hearing test, no improvement. but had bad case of acid reflux. treated acid reflux as he said that contributes to sinusitis. Tuning fork test revealed higher sound on defective ear suggesting conductive loss. Burping brings no pressure to right ear. Acid reflux is now controlled but still have post nasal drip since three months. DID comprehensive blood test including kidney liver B12 etc etc. All clear except Vitamin D and taking supplements now.
April 2019 : returned to ENT 3 did hearing test same as March no improvement. low frequency 30DBl and high frequency 10 DBhl pure tome average of right side ear is 35, Eustacian tube -> He said the tymapnogram shows normal so he is not favoring eustacian tube dilation. Grommets -> he wanted to do it for me but since hearing shows no improvement he is no favoring this. ototoxicity (Root canal brufen) -> He ruled it out as he said my issue is purely mechanical because of air bone gap and tuning fork test. -> Otosclerosis – He referred me to HRCT of temporal bone as that thin slices of imaging is not available in my area and come back with result. I told him my eustacian tube is still sticky and he mentioned that that may be the case – use an otovent but that should not cause the hearing loss that I experience. Tuning fork test revealed higher sound on defective ear suggesting conductive loss. burping rings no pressure to right ear. Acid reflux is no controlled still have post nasal drip.
April 2019 : Went to dentist and showed my impacted wisdom tooth. He suggested there may not be pain but it can be infected and take it out. ENT agrees with him but ENT 3 is totally against the fact that wisdom tooth can cause hearing loss.
I am totally lost what is causing my conductive loss and tinnitus. Months of October to March were extreme stress months for me personally and professionally and my ear is just causing more anxiety. My hearing seems to have base lined around average 35 db but not sure what I can do to get it back to normal. i want to avoid surgery.
I hope someone can help.
Hi Concerned R:
Was the root canal on an upper molar, as opposed to your lower jaw or on a front tooth? Upper molar roots are close to the inner ear and thus sometimes can cause problems moreso than for your other teeth.
Since you took both Amoxicillin (Augmentin) and Ibuprofen (Brufen), there is always a chance that your tooth problems resulted in ear problems from these two drugs. Both of these drugs are moderately ototoxic.
The cold/fever virus you caught could have invaded your inner ear and caused the same kinds of problems the drugs could have caused. This could have given you the plugged feeling and hearing loss without any signs of infection.
However, if that had happened, you should have had a sensorineural hearing loss rather than a conductive loss. So something isn’t adding up here. If your Eustachian tube was clogged your tympanogram shouln’t have been Type A — normal. The peak shouldn’t have been very high. I can see why this confused your ENT.
As long as your Eustachian tube is clogged, you can expect to have some degree of conductive hearing loss. Gastric reflux if it gets into the bottom of your Eustachian tube can clog it up and inflame it so you have a conductive loss without any infection showing up in your middle ear.
So as I see it, the main problem is that your Eustachian tube is not clear of “gunk” for whatever reason and until that is cleared up, I wouldn’t look further afield such as otosclerosis. Since otosclerosis is inherited, if you have it some of your ancestors (mother maybe since it is more common in women) should have had it also. If there is no history of otosclerosis in your family, I doubt that is your problem.
I’m with you in not doing any surgery procedures at this time. Do you think any acid reflux comes up periodically and inflames the base of your Eustachian tube?
Cordially,
Neil
I took Augmentin for 3 days and I woke up with both ears feeling very full, nausea and increase in my Tinnitus. Anything I should do to help this? I stopped the antibiotic
Hi Dan:
You didn’t say how long ago this was. If it was only 2 or 3 days ago, then what I’d do is take high doses of N-acetyl-cysteine (up to around 1,800 mg/day) to try to zap the free radicals in your inner ears before they cause permanent damage. Your body converts this into glutathione–it’s most powerful anti-oxidant. If it is more than a week ago, this probably won’t help much as the damage will already be done. But I’d take supplements such as zinc picolinate, magnesium threonate, Vitamin D3 and Vitamin C. to give your ears the best chance of functioning as best they can. (Personally, I take these supplements every day as a maintenance dose–but I’d take therapeutic doses if I needed to such as if drugs were hurting my ears).
Cordially,
Neil
I had sore throat, headache,sinus pain, pressure in my head, pain in my left ear, dizziness. Doctor put me on Augmentin. I had nausea / vomiting the next day. The next day I had diarrhea. Went to the hospital the next day. Then I lost my hearing in the left ear. Ringing in that ear. Vertigo and permanent sensorineural hearing loss is what ENT told me.
Hi Barb:
It’s hard to tell whether your ear problems are the result of a viral attack from the cold virus you had, or from the Amoxicillin you were given to combat the symptoms. It could have been a combination of both.
Cordially,
Neil
I also took Amox-clav for 10 days for a sore throat that was not going away. I also took amoxicillin for 4 days after. A week later after taking these meds, ringing in my ears and I can tell I have diminished hearing. My hearing was fine before I took these antibiotics. I never took these drugs before. Very frustrated!
I took augmentin for a foot infection. within a day i had loud ringing in my ears. i checked online and found the possibility it could be from augmentin and stopped taking it within 36 hours. It is now two months later, the ringing hasnt stopped. How is this drug allowed on the market. Why arent they culpable for the damage they cause to us.
I previously took amoxicillin for infections with no side effects, but i was prescribed augmentin by the chemist this time as an equivalent product. Horror story.
Hi Saeed:
You are not alone. Numbers of people have developed permanent tinnitus from taking Augmentin. If you took all the drugs off the market that caused side effects, you’d be left with no drugs. So whenever you take a drug you accept that there is a risk. Unfortunately, you can’t choose the risk you are willing to accept. Resulting side effects may be mild or severe and temporary or permanent. As with everything else in this life, we are free to choose what we do, but we are not free to choose the consequences.
Augmentin is a combination of Amoxicillin and Clavulanic acid (Clavulanate). As far as I know, it is the Amoxicillin that is ototoxic.
Cordially,
Neil
Hi Neil, I wrote to you a week or two back about my experience. Long story short again, had second Pfizer jab November 17’th, December 8’th had very muffled hearing in my right ear one morning and pressure on my face. Called the GP and he had a quick look, proclaimed ear infection and gave me a 6 day course of Amoxicillin. I was sure the vax had something to do with the onset of high volume tinnitus (I still do) but now after reading the comments here I now feel that the Amoxicillin may be the culprit, or one of several factors or chain of events that lead to this incessant ringing.
Quite annoyed now to be honest that the thing I went to the doc to get help for may have ended up being the thing that caused my this problem.
While I’m here, I will say that I didn’t get any sleep hardly at all for 2 weeks from December 8’th until a week later or so until I was prescribed Temazapam which does help me get to sleep but I realise this sort of Benzodiazepines are meant to be short term and not a real fix. They’ve helped me now but I realise that I need to get off them ASAP and try and get a normal sleep routine again. So, if it’s caused by amoxicillin and this being a month to the day since I first took them does that mean the damage is done or will it possibly fade in time?
Cheers Neil
Hi Mark:
It’s hard to say whether the Pfizer jab was the culprit or the Amoxicillin, or a combination of both.
Since a month or more has gone by, your tinnitus may tend to be permanent, but there is no reason it won’t fade in time. In order to facilitate this, you need to think of your tinnitus as a totally unimportant useless sound that is safe to ignore–then ignore it, rather than as a threat to your well-being in any way, because your brain won’t let you ignore anything it considers a threat.
So don’t worry and fret about your tinnitus–what’s done is done. Focus instead on the loves of your life and thereby ignore your tinnitus and it will begin to fade away into the background.
Cordially,
Neil
Hi Neil,
I hope you see this quickly as I’m trying to decide on the least ototoxic antibiotic for an ear infection that’s been brewing for about a week giving me some tinnitus and a feeling of fullness in my inner ear. I was given a week’s worth of Prednisone and it’s helped the tinnitus a bit but the ear infection/pain continues.
I was given the option of Augmentin but after reading your article with your findings about it being ototoxic I opted against it. I have read that Clavulanate is the ototoxic part so would you recommend pure Amoxicillin?
Anyway you seemed to speak well of the Cephalosporins which Cefdinir is one of on this Augmentin post. You said “as a class they are not all that ototoxic, but there is still variation within that class. The least ototoxic ones include Cefadroxil, Cefaclor and Cefazolin.”
I decided to try Cefdinir which I took for a couple days. I did notice a slight new ringing after my 4th pill so I became worried about continuing it. Though admittedly after not taking anymore Cefdinir the ringing has stayed about the same and the ear pain has increased again. I saw this for Cenfinr so I felt my worries were confirmed: https://www.ehealthme.com/ds/cefdinir/tinnitus/
Here is there info for Amoxicillin https://www.ehealthme.com/ds/amoxicillin/tinnitus/
And for Cefaclor https://www.ehealthme.com/ds/cefaclor/tinnitus/
Should I try pure Amoxocillian, continue the Cefdinir and hope for the best, push for another Cephalosporin like Cefaclor, or try another class of antibiotic entirely? Alternatively should I just wait and let my ear continue to attempt to heal itself using the Prednisone? I feel a bit paralyzed knowing that antibiotics could make it worse but so could letting the infection continue on.
Thank you for your time and I look forward eagerly to the next edition of your book.
For a little more context, the initial tinnitus started as a COVID symptom. Then I got better but had clogged ears, little pain alternating between the ears, and of course the tinnitus. The doctor felt my ears were a little red and felt that being stuffed up from COVID left me with a little gift of an ear infection so their thoughts were antibiotics and prednisone. I’ve taken the prednisone but haven’t found an antibiotic that is the least ototoxic hence the above post.
Thanks again.
Hi Sharon:
COVID can cause tinnitus and I don’t know of any drugs that work for tinnitus from that cause.
Cordially,
Neil
Hi Sharon:
First, I can’t just tell you the lest ototoxic antibiotic for your ears. You need to ask your doctor for a list of drugs that would do the job. And the doctor can’t do that unless he takes a culture to see what “bug” you have. Only then, I can put them in order of least to most ototoxic in my opinion.
The information I have about the ototoxicity of Amoxicillin/Clavulanate (Augmentin) is for this combination, i.e. Augmentin, not for Amoxicillin by itself. I do not have any information that indicates that Clavulanate is more ototoxic than Amoxicillin.
Cefdinir is not very ototoxic. I rate it as a Class 1–very low risk, but that doesn’t mean that some people don’t get tinnitus and hearing loss, etc. from taking it. So it could be a good choice. But since you got more ringing after taking it, maybe it is not for you. (Or maybe it was coincidental and the tinnitus wasn’t from the Cefdinir at all.)
If I were you I don’t think I’d risk the Amoxicillin. The cephalosporins seem to still be a better choice regarding ototoxicity.If your ears aren’t too bad, you may just want to let your body take care of things, and only decide to take antibiotics if things get worse.
Cordially,
Neil
Hello Dr Bauman,
Thank you for your insights on this forum.
I would like your view on my concern – should you stop antibiotic after 1 day and try to heal naturally, or try changing to less ototoxic antibiotics.
And the possible negative effects on inner ear with some condition, if I choose to stop taking it all.
I got prescribed Co-amoxiclav 500/125mg for my ear infection yesterday, and been researching about this medicine and came across this resource.
My background:
I have been suffering from acoustic trauma/ shock since May after an exposure to loud cymbal sound. I became more sensitive to big or high pitch sound than other people would react.
My hearing is good across all range, -5 to 15, but a drop at 35 or 25 at 16khz on Left ear which is the tinnitus match I have in both ears.
I will need to do another hearing test for this new ear infection. ( when is the best timing?)
Ear infection:
I started to develop ear ache and warm, wet inner ear sensation on Sunday evening, 3 days ago. I think I smelled funny during the day while having a tea with my friend. But I smell funny everyday for the past 2 years I didn’t care too much.
Tinnitus increased in both ears. Ear pain, fullness and warm sensation. Took painkiller.
On the next day, I woke up with headache, heavy but lightheaded feel at the same time. It got worse during the day and my body felt warm while I didn’t have fever. I did lateral flow test just in case, and tested negative.
I’m on period but it felt different than the headache I could have usually. Took ibuprofen but i still struggled with headache and ear pain. Took ibuprofen and paracetamol before going to bed.
On Tuesday, I think it got somewhat better, but still morning so I don’t know if it could have gotten worse. I went to hospital GP service and got seen by a doctor. He said there’s an inflammation near the eardrum in the right ear. Got prescribed the said medication. Took 3 times for a day. The symptoms relaxed and I only took ibuprofen 1 time around noon.
Today, Wednesday, I went in the GP service again to ask if I could stop antibiotic or change it. Because I was scared by the result I casually typed in on Google, if amoxicillin is harmful to hearing. I was surprised.
Because I have this ongoing issue with my inner ear, ( I am yet to take ABR and Ecog, but my ENT doctor said I might have inner ear disorder. I do have tendency to hyperacusis.) so i thought I might get affected easily than usual people.
The GP said I could stop it for now and see how the symptoms goes. Or, I take the full 7 days course. No option to stop after few days or so if the symptoms get better.
For today, I have stopped Co amoxiclav. I was worried for hearing loss, but I ended up worrying about resistance all day as well, I think whatever I chose I must have been worried all day…
I took it for 1 day already, so I am worried that it might risk bacterial resistance.
My ear now seems to look okay but I wonder if I should restart an alternative antibiotics, or if I can try to heal it naturally.
What I worry the most is, how my choice of not taking or taking antibiotics would impact the inner ear ongoing issue.
Also, if I were to restart the antibiotics course, skipping 1 or 2 day and starting again could risk more of resistance etc.
I may need antibiotics during the rest of my life, so I am not sure what is the best choice for longer term. Of course I want to protect my hearing as I want to do music for the rest of my life, still new to it but I want to live my joy.
It’s crazy that I become so prone to one thing to worry and my mind is all consumed. So difficult to handle other things.
I realise it’s quite a long post. Sorry. Thank you for reading. My ENT doctors say it’s up to you whether I take antibiotics or not, but I wanted to know more factors to decide.
Your insights are much appreciated.
Best wishes
Hi HM:
My three rules of thumb is to take the least ototoxic antibiotic that will do the job–take the lowest dose that will do the job–and take it for the shortest time that will do the job.
If you can heal naturally, that would be the best way. If not then you can try natural antibiotic herbals. And failing that, use prescription antibiotics. That’s the way I do it.
For a hearing test, I’d wait until 2 or 3 weeks after the ear infection is gone and the “gunk” in your middle ear and Eustachian tube has drained out. Having it before this occurs will show a greater temporary hearing loss.
If your doctor doesn’t care whether you stop the antibiotic or not, or finish the prescription, my policy is to take the antibiotics until the infection is dead and one more day for insurance, then stop as per my rules of thumb above.
Doctors traditionally have said you have to take the whole prescription because if you don’t the remaining bugs will build up antibiotic resistance. Recent research has proven this to be false, and it is safe to stop once the infection is gone. Since that study was published I haven’t heard of much change in doctors prescribing instructions to patients.
Your hyperacusis and your ear infection are separate conditions and I don’t see why one should affect the other.
If you ear is ok now, there is no reason to restart the antibiotics.
Cordially,
Neil
I’m given augmentin for tonsillitis many times before and never triggered tinnitus…but last time I used it I got tinnitus. Of course I’m still unsure. Before usage I had a noise in my ears like anyone catched cold could hear… Then I took augmentin and first pill made a different noise – high volume then gone. I never guessed it…now I have tinnitus but not so severe. Just if I have dream while sleeping my ears becomes noisy and wakes me up. Damn.
Hi Hakan:
Other people have also reported getting tinnitus from taking Augmentin for congestion related to a cold. It does happen.
Cordially,
Neil