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Authored by

Ubayd Ali

Superintendent Pharmacist

Registration Number: 2219322

NHS Pharmacist and founding member of HEBA, with years of experience in healthcare across innovative organisations.

Reviewed by

Sufyan Tahir

Clinical Governance Lead

Registration Number: 2221275

Review Date 1 August 2025

Next Review 1 August 2027

Published on 7 January 2023

Last Update 1 August 2025

Overview

What is Dexamethasone 0.1% with Neomycin 0.5% and acetic acid 2% spray?

It is a prescription-only medication used to treat outer ear infections (otitis externa).

What is the spray used for?

The Ear Spray works by targeting ear infections, mitigating the pain and discomfort caused by inflammation, and preventing bacterial growth in the outer ear. However, you cannot use this medication if you have a perforated eardrum. The spray is for external use only. You cannot use it to treat a blocked ear.

How does it work?

It combines three active ingredients to tackle infection, inflammation, and discomfort.

Dexamethasone – a corticosteroid that reduces inflammation and swelling
Neomycin sulfate – an antibiotic that kills bacteria
Acetic acid – helps create an acidic environment to prevent bacterial growth

Your symptoms should ease within 48 hours of using the ear spray. However, if your symptoms have not improved within seven days of use, you should discuss them with your doctor.

Side effects

Common / Local reactions:

Irritation in the ear (burning, stinging, or itching)
Skin sensitivity or redness in the ear canal

Hypersensitivity reactions

Allergic reactions, particularly due to neomycin
Symptoms may include:
Rash or itching
Swelling or worsening irritation
Contact dermatitis can occur with prolonged use

Less common / rare

Ototoxicity (hearing damage) – rare, but risk increases if used when the eardrum is perforated
Superinfection – prolonged use may allow non-susceptible organisms (e.g. fungi) to grow

Important warnings

Stop treatment if severe irritation or allergic reaction occurs
Avoid prolonged or repeated courses due to risk of sensitisation (especially to neomycin)
Always ensure the eardrum is intact before use

If you encounter these side effects when using the antibiotic spray, call 999 or contact a medical professional:

Directions

Adults, elderly, and children:

Apply 1 metered dose (1 spray) into the affected ear three times daily
Duration of treatment:
Continue for 7 days
(Treatment should not normally exceed 7 days unless advised by a healthcare professional)

How to use

Before using a new bottle of Dexamethasone/ Neomycin sulfate /
Acetic acid ear spray:

Shake well before use.
Press the pump down several times until you get a fine spray.
Make sure you do not point the nozzle at yourself or someone else.
Each time the pump is pressed down one measured dose will be
delivered.

If you have not used Dexamethasone/ Neomycin sulfate / acetic acid ear spray for more than a week, press the pump a few times until you get a fine spray again, and then follow the instructions above.

Shake the bottle well before use
Hold the bottle upright and insert the nozzle gently into the ear
Press the pump once to deliver a measured dose
Keep the head tilted for a few minutes after application to allow the medication to reach the ear canal

Precautions

For use in the ear only (otic use)
Do not use if the eardrum is perforated
Avoid contact with the eyes
Discontinue if irritation or sensitivity occurs
If symptoms persist after 7 days, seek medical advice

Informational resources

Patient information Leaflet - Ear Infection Treatment Spray

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