Antifungals: getting an earful

My father is in his mid-60s and suffers from hearing loss. He has to wear hearing aids in both ears and, inevitably, he suffers from infections and painful ears. He went to his doctor to ask for drops to reduce the pain and was prescribed Canesten AF spray.

He picked up the prescription, went home and sprayed it into his ears, only to feel an intense burning, which resulted in his ears becoming even more painful.

He looked on the medicine box and noticed the wording ‘for Athlete’s Foot’. He read the leaflet that accompanied the spray, and discovered that it stated very clearly that it should never be used near the eyes, ears or mouth.

He went back to the pharmacist who had made up the prescription to check that he had received the correct drug. Yes, it was exactly as it said on the prescription. He returned to the doctor’s office and told the receptionist of his concern. He was later told that this spray has been prescribed before for painful ears without incident.

I would like to know why a product that says that it should not be used in the ears should be prescribed for just that purpose. – Gillian Grant, via e-mail

WDDTY replies: In their hurry to get the patient standing in front of them out the door, doctors are notorious for prescribing without bothering to read the small print.

In all datasheets and physician guidebooks, doctors are clearly warned only to use this drug for external use only, and it should never be allowed to come into contact with the eyes, ears or mucous membranes (such as those lining the respiratory tract), so it’s also not supposed to be inhaled. If the other patients given this spray for ear infections didn’t experience any side-effects, they must have been extremely lucky.

Some of the main problems with this drug involve severe skin irritation, including hives, skin rash, burning, redness, blistering and even peeling, stinging or swelling.

For burning ears, your father is better off going to a naturopath and requesting herbal eardrops made up of garlic, mullein flower, Calendula and St John’s wort, found to prevent ear infection in children (Arch Ped Adolesc Med, 2001; 155: 796-9). But do not use tea tree oil in the ears, as it was found to cause ear damage in animal trials.