Gentamycin Cream: Usage, Duration, and Side Effects

Gentamicin cream medication issues?

Hello, I have developed a pimple inside my left ear that hurts when pressed.
After a consultation, the doctor prescribed Gentamicin cream, stating that it can also be applied to pimples on my chin (as I usually have a tendency for persistent chin acne).
However, I was not informed about the duration of the treatment.
After researching, I found that this cream is an external antibiotic, and I am concerned about antibiotic resistance and the potential for long-term use to cause hearing damage (unsure if this is what is referred to as ototoxicity).
Therefore, I would like to ask the following questions, and I appreciate your help and advice:
1.
I have been applying the cream to my left ear for 2 days, once in the morning and once at night.
I feel that the pain has decreased, but sometimes I experience a bit of tinnitus in my left ear.
Is this a normal phenomenon? Will it return to normal after stopping the medication?
2.
How long is the typical duration for this cream treatment? Should I stop using it once the pimple has resolved and is no longer painful?
3.
When applying it to chin acne (currently applying once at night), should I only apply the medication when there is a pimple, and stop once it has cleared, or is it recommended to use it for a certain number of days as part of a treatment regimen?

Niming, 20~29 year old female. Ask Date: 2023/12/21

Dr. Wu Yuxin reply Dermatology

There is no standard answer for how long to apply the ointment; it depends on the healing progress of the lesion itself.
The likelihood of the ointment causing ototoxicity is very low.

Reply Date: 2023/12/21

More Info

Gentamycin cream is a topical antibiotic that is commonly used to treat bacterial infections on the skin. It contains gentamicin, which is effective against a variety of gram-negative and some gram-positive bacteria. While it can be beneficial for treating localized infections, there are important considerations regarding its usage, duration, and potential side effects, particularly when used in sensitive areas like the ear.

1. Usage and Duration
Gentamycin cream is typically applied to the affected area once or twice daily, depending on the severity of the infection and the physician's recommendations. In your case, using it on the left ear and chin is appropriate, especially if the doctor has advised it. The duration of treatment can vary; generally, it is recommended to continue using the cream until the infection has resolved, which can be indicated by the disappearance of symptoms such as pain and redness. However, it is crucial not to use it for an extended period without medical supervision, as prolonged use can lead to antibiotic resistance and other complications.

2. Ear Symptoms and Concerns
You mentioned experiencing some ear ringing (tinnitus) after using the cream. While this is not a common side effect of topical gentamicin, it is essential to monitor this symptom. If the tinnitus persists or worsens, it would be wise to consult your healthcare provider. Generally, if the medication is causing side effects, discontinuing it should lead to a return to normal function, but this can depend on individual circumstances.

3. Potential Side Effects
Topical gentamicin can cause local irritation, redness, or rash at the application site. In rare cases, it may lead to systemic absorption, especially if used over large areas of the skin or on broken skin, which could potentially affect hearing. This is particularly concerning in the case of prolonged use or if the cream is applied near the ear canal. It is crucial to follow the prescribed duration and not exceed the recommended application frequency.

4. Antibiotic Resistance
Your concern about antibiotic resistance is valid. Overuse of topical antibiotics can lead to resistant strains of bacteria, making future infections harder to treat. Therefore, it is advisable to use gentamicin cream only as directed and to avoid using it for minor skin irritations or conditions that do not require antibiotic treatment.

5. Application on Acne
For treating acne on the chin, it is generally acceptable to apply the cream only to active lesions. Once the acne has resolved, you can discontinue use. There is no strict guideline on how long to use it for acne, but many dermatologists recommend a course of treatment lasting a few days to a couple of weeks, depending on the severity of the acne and the response to treatment.

Conclusion
In summary, while gentamicin cream can be effective for treating localized bacterial infections, it is essential to use it judiciously to avoid complications such as antibiotic resistance and potential side effects, especially in sensitive areas like the ear. If you have any concerns about the symptoms you are experiencing or the duration of treatment, it is best to consult your healthcare provider for personalized advice. Always prioritize open communication with your doctor regarding any side effects or concerns during your treatment.

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