Rosh Emergency Medicine Practice Test

Which medication should be administered to a patient with right ear pain and discharge after using a cotton swab?

1. Acetic acid-hydrocortisone otic drops

2. Amoxicillin-clavulanate oral

3. Ciprofloxacin intravenous

4. Neomycin-polymyxin B-hydrocortisone otic drops

The correct answer is: Neomycin-polymyxin B-hydrocortisone otic drops

The recommended medication for a patient with right ear pain and discharge, especially after using a cotton swab, is neomycin-polymyxin B-hydrocortisone otic drops. This combination is effective for treating external ear infections, such as otitis externa, which can result from trauma or irritation, often exacerbated by the use of cotton swabs. Neomycin and polymyxin B are antibiotics that target the bacterial pathogens commonly associated with these infections, while hydrocortisone serves to reduce inflammation and provide symptomatic relief. The composition of this medication makes it particularly suitable for a case that likely presents with signs of infection alongside irritation from the cotton swab usage. Other treatment options, while beneficial in different contexts, do not align as closely with the specifics of this case. For instance, acetic acid-hydrocortisone otic drops may be used for mild infections or for patients who cannot tolerate neomycin, but they may not have the same breadth of antibacterial activity. Amoxicillin-clavulanate oral is typically reserved for established middle ear infections or more severe infections, as it is not specifically indicated for superficial ear canal issues like those likely presented here. Lastly, intravenous ciprofloxacin is not necessary and would