Healthcare professionals have been advised to treat children and young people with anaesthetic-analgesic ear drops instead of paracetamol or ibuprofen.  

Updated NICE guidelines on middle ear infections – acute otitis media (AOM) – which were published last week (11 March), - said that anaesthetic-analgesic ear drops can be given to patients who are experiencing pain that is usually associated with AOM.  

This approach aims to ‘further reduce’ the overuse of antibiotics for this common ear infection, the health watchdog explained.  

NICE’s 2018 acute ear infections antimicrobial prescribing guidelines said most common ear infections should not be treated with antibiotics as most children and young people get better within three days without antibiotics.  

NICE suggested that patients should be treated with paracetamol or ibuprofen with the option of a back-up antibiotic prescription. 

However, a study conducted in 2021 found that anaesthetic-analgesic ear drops resulted in a greater reduction of antibiotic consumption in children presenting with AOM, compared with those who were prescribed paracetamol or ibuprofen

According to NICE, the pain- relieving drops can be used if an immediate antibiotic prescription is not given and there is no ear drum perforation or otorrhoea (discharge). 

As it stands, Otigo (phenazone and lidocaine hydrochloride) manufactured by Renascience Pharma is the only available form of anaesthetic-analgesic ear drops in England. 

The anaesthetic-analgesic ear drops are  prescribable with four drops being applied two or three times a day for up to a week. 

Dr Paul Chrisp, director of NICE’s centre for guidelines, said: ‘Based on evidence, our committee agreed that ear drops containing anaesthetic and an analgesic may reduce antibiotic consumption and relieve pain in children who did not need immediate antibiotics. 

‘The evidence shows antibiotics are not needed by most children and young people with middle ear infections. We must make sure the people who need them are given them, but routine prescribing in all cases isn’t appropriate’.  

This comes as antimicrobial resistance is reportedly the leading cause of death worldwide. A study in The Lancet, published last month, found that antimicrobial resistance kills about 3,500 people every day worldwide.