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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hi. I was on a z pack antibiotic for 5

Answered by
Dr.
Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 2794 Questions

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Posted on Mon, 18 Mar 2019 in Ear, Nose and Throat Problems
Question: Hi. I was on a z pack antibiotic for 5 days due to double ear infection and suspected middle ear infection. The pain went away but I remained dizzy and nauseated. Seven days later, my doctor prescribed augmenton antibiotic and otc muscinex 1200. She cannot prescribe a steroid because I am diabetic. That was 3 days ago. The dizziness and nausea have not improved at all and now my right ear aches. What should I do.
doctor
Answered by Dr. Antoneta Zotaj 2 hours later
Brief Answer:
Serous otitis media may be the cause- advises given below

Detailed Answer:
Hi,

Thank you for asking at "Ask a Doctor" service.
I carefully went through your query. I think you are having serous otitis media (also called otitis medica with effusion) which is collection of clear fluids behind the eardrum. This may happen with a viral infection most of the times especially in adults and also when infection affects both ears. The same virus that affects the medial ear space can also affect the inner ear space affecting the structures responsible for the balance and causing dizziness and nausea.

Generally antibiotics do not help in this case and this is probably why you do not see much improvement even though you are getting a second antibiotic that is normally quite good for ear infections (bacterial infections).

Serous otitis media may take a few weeks before it starts to reabsorb and feel better. Unfortunately there is no specific drug that will help the fluids clear earlier. Antibiotics, steroids, antihistamines and decongestants are used sometimes but studies do not find them effective.

Normally serous otitis media does not cause severe ear ache but a dull pain (rarely sharp pain) and heaviness in the ear mostly. You can take some paracetamol and ibuprofen to help with it (after food because ibuprofen can hurt the stomach).

If you are not better with the pain in 3-4 days or you notice any worsening or if you develop any fever or new symptoms you will need to see your doctor.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Antoneta Zotaj 2 hours later
Thank you for the explanation.
Is there anything I can take or do for the dizziness? The pain and pressure are bearable; the dizziness is causing nausea and causing me to miss work because I cannot safely drive.
doctor
Answered by Dr. Antoneta Zotaj 17 minutes later
Brief Answer:
A few medications mentioned below

Detailed Answer:
Hi,

The drugs to use for the dizziness and nausea are in this case called vestibular suppressants. There different classes that can be tried:
- antihistamines like meclizine and dimenhydrinate which are also drugs for motion sickness. These are the first to be trued because are generally well tolerated. Promethazine can be an alternative but has higher chance of sedation and problems with driving.
- another option are benzodiazepines like diazepam or lorazepam, these cause sedation and are not recommended during the day. They should not be taken for longer than a week due to risk of dependence.
- steroids like dexamethasone but in your case due to diabetes it is not a good choice
- antiemetics like metoclopramide or ondaserton can be tried to reduce nausea and vomiting. They can be combined with the antihistamines mentioned above.

Meanwhile make sure you drink plenty of water and rest as needed.

I hope this answers to your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician
Above answer was peer-reviewed by : Dr. Raju A.T
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