Drug Class: Topical Antibiotic + Corticosteroid Combination | Form: Ear Drops (Otic Solution) | Prescription Status: Prescription Only (Rx) — DRAP Registered
What is Dexatob Ear Drops 5ml?
Dexatob Ear Drops 5ml is a combination ear drop medicine containing two active ingredients — Tobramycin, a powerful antibiotic, and Dexamethasone, a corticosteroid (steroid). It is used to treat bacterial infections of the outer ear canal (کان کی نالی کا بیکٹیریل انفیکشن) while simultaneously reducing the inflammation, swelling, redness, and itching that accompany these infections. Most outer ear infections involve both bacterial growth and inflammatory reaction — Tobramycin addresses the bacterial infection directly while Dexamethasone rapidly calms the inflammatory response. This dual action makes Dexatob particularly effective for conditions like otitis externa and infected ear eczema where both infection and inflammation need to be treated together. Dexatob Ear Drops must only be used as prescribed by your doctor and must never be used if the eardrum is perforated or damaged.
What is Dexatob Ear Drops Used For?
Dexatob Ear Drops 5ml is approved for the treatment of the following conditions:
- Otitis Externa (Outer Ear Canal Infection) — bacterial infection of the skin lining the ear canal causing pain, swelling, discharge, and itching (کان کی بیرونی نالی کا انفیکشن)
- Swimmer's Ear — infection and inflammation of the outer ear canal caused by water remaining in the ear after swimming, bathing, or exposure to humid conditions
- Infected Eczema of the Ear Canal — bacterial infection occurring on top of inflamed or eczematous skin inside the ear canal, requiring both antibiotic and steroid treatment
- Inflammatory Conditions of the Outer Ear with Secondary Bacterial Infection — outer ear conditions where inflammation and bacterial infection are present together
- Acute and Chronic Otitis Externa — both sudden-onset and long-standing outer ear canal infections with significant inflammation and redness
- Post-Traumatic Ear Canal Infections — bacterial infection and inflammation following minor scratching or trauma to the ear canal skin
How Does Dexatob Ear Drops Work?
Dexatob Ear Drops combine two medicines that target the infection and inflammation through different but highly complementary mechanisms:
Tobramycin (Antibiotic): Tobramycin is an aminoglycoside antibiotic that kills bacteria by entering bacterial cells and binding to their ribosomes — the structures bacteria use to produce the proteins they need to survive and multiply. By disrupting this protein production process, Tobramycin prevents bacteria from functioning and causes them to die. It is effective against a wide range of bacteria commonly responsible for outer ear infections — particularly Gram-negative bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus, which are among the most frequent causes of otitis externa. Tobramycin acts locally within the ear canal with minimal absorption into the bloodstream, making it safe for topical use.
Dexamethasone (Corticosteroid — Steroid): When bacteria infect the ear canal, the body's immune response causes inflammation — triggering redness, swelling, heat, and pain in the ear canal tissues. While this response is the body's natural defence mechanism, excessive inflammation can make symptoms significantly worse and delay recovery. Dexamethasone is a potent corticosteroid that works by suppressing the inflammatory chemicals — particularly prostaglandins and cytokines — that cause this reaction. By reducing inflammation quickly, Dexamethasone relieves the swelling that narrows the ear canal, reduces pain and itching, and creates a better environment for Tobramycin to work effectively against the infection. Together the two ingredients treat both the cause (bacteria) and the symptoms (inflammation) simultaneously.
Dosage and Administration
⚠️ For use in the ear only — never swallow ear drops or place in the eyes. Never use these drops if the eardrum is perforated. Always follow your doctor's instructions on dose and duration exactly. Do not use for longer than prescribed — prolonged steroid use in the ear can have serious consequences.
| Patient Group | Dose | Frequency |
|---|---|---|
| Adults and children over 12 years | 3 to 4 drops into the affected ear | 3 to 4 times daily |
| Children under 12 years | 1 to 2 drops into the affected ear | 3 times daily — as prescribed by doctor |
How to Apply Dexatob Ear Drops Correctly:
- Wash your hands thoroughly before handling the bottle
- Warm the bottle gently by holding it in your hands for 1 to 2 minutes — cold drops applied directly into the ear can cause dizziness
- Shake the bottle gently before use if instructed on the label
- Tilt your head to one side so the affected ear faces upward
- Gently pull the outer ear upward and backward (for adults) or downward and backward (for young children) to straighten and open the ear canal
- Hold the dropper just above the ear opening — do not insert the dropper tip inside the ear canal
- Apply the correct number of drops
- Gently press the small flap of skin (tragus) over the ear opening several times to help the drops travel deep into the ear canal
- Keep your head tilted for 1 to 2 minutes to allow the drops to settle and coat the canal properly
- Repeat for the other ear if both ears are infected and your doctor has prescribed treatment for both
- Replace the cap tightly and store the bottle correctly after use
- Complete the full prescribed course even if symptoms improve before the course ends — stopping early can allow the infection to return
- Treatment is typically continued for 7 days — do not extend use beyond this without your doctor's advice
- Do not insert cotton wool or ear plugs after applying unless specifically advised by your doctor
Active Ingredients
| Ingredient | Strength | Role |
|---|---|---|
| Tobramycin | As per formulation per ml | Aminoglycoside antibiotic — kills bacteria causing the ear infection |
| Dexamethasone | As per formulation per ml | Corticosteroid — reduces inflammation, swelling, redness, and itching |
Please check the product label or ask your pharmacist for the exact strength of each ingredient per ml in the specific pack dispensed to you.
Who Should NOT Use Dexatob Ear Drops?
Do not use these drops if you or your child:
- Have a perforated eardrum (پھٹا ہوا پردہ کان) — this is the most critical contraindication. Tobramycin reaching the middle or inner ear through a perforation can cause permanent hearing damage and balance problems
- Have a suspected middle ear infection (otitis media — درمیانی کان کا انفیکشن) — middle ear infections are a different condition requiring different treatment assessed by a doctor
- Have a viral ear infection — including those caused by Herpes simplex or Varicella (chickenpox virus). Dexamethasone steroid can worsen viral infections
- Have a fungal ear infection (otomycosis — پھپھوندی سے کان کا انفیکشن) — steroids can worsen fungal infections and these require antifungal treatment
- Are allergic to Tobramycin, Dexamethasone, any other aminoglycoside antibiotic (e.g., Gentamicin, Neomycin), or any corticosteroid medicine
- Have had ear surgery — particularly involving the eardrum or middle ear — without consulting your surgeon first
- Have grommets (ear tubes) fitted — consult your doctor before use
- Are under 1 year of age — consult a specialist before use in very young infants
Tell your doctor before use if:
- You are unsure whether your eardrum is intact — your doctor must examine the ear before prescribing drops
- There is any discharge from the ear that may indicate a ruptured eardrum
- You have a history of recurrent ear infections or chronic ear disease
- Symptoms do not improve within 3 to 4 days of starting treatment
- You have previously had an allergic reaction to any ear drops or antibiotic medicines
- You are pregnant or breastfeeding — your doctor will assess safety before prescribing
Side Effects
Like all medicines, Dexatob Ear Drops can cause side effects. Because these drops are applied locally in the ear, side effects are generally mild and limited to the ear area. Not everyone will experience them.
Common Side Effects (relatively frequent):
- Mild temporary stinging, burning, or discomfort immediately after applying the drops — usually settles within a few minutes
- Mild itching inside the ear canal — often temporary and improves as the infection clears
- Feeling of fullness or pressure in the ear — usually resolves as swelling reduces with treatment
- Temporary dizziness immediately after application — particularly if the drops are cold when applied
Serious Side Effects (less common — seek medical help immediately):
- Allergic contact dermatitis — Tobramycin and other aminoglycosides can cause skin sensitisation. Signs include worsening redness, intense itching, swelling, blistering, or a new rash developing around or inside the ear — stop the drops and consult your doctor immediately
- Severe allergic reaction — sudden widespread rash, swelling of the face, lips, or throat, difficulty breathing — seek emergency help immediately
- Fungal superinfection — prolonged use of steroid-containing ear drops can allow fungi to overgrow in the ear canal. Signs include new or worsening itching, thick discharge, or unusual ear odour after initial improvement — inform your doctor
- Hearing changes or new hearing loss — any new or worsening hearing loss during treatment must be reported to your doctor immediately — do not continue drops if hearing changes occur
- Worsening of symptoms — if pain, discharge, or swelling increases rather than improving after 3 to 4 days, stop and see your doctor — the infection may need reassessment
- Signs of systemic steroid absorption — very rare with topical ear drops used short-term but report any unusual weight gain, facial swelling, or mood changes to your doctor if using for extended periods
If you notice any serious side effects, stop using the drops and go to the nearest hospital or doctor immediately.
Drug Interactions
Dexatob Ear Drops are applied directly into the ear canal and very little medicine is absorbed into the bloodstream. Significant systemic drug interactions are therefore unlikely with short-term use. However:
| Consideration | Details |
|---|---|
| Other ear drops | Do not use other ear drops at the same time unless specifically advised by your doctor — allow at least 30 minutes between different ear preparations |
| Systemic aminoglycoside antibiotics (e.g., Tobramycin or Gentamicin injections) | If the patient is also receiving aminoglycoside antibiotics by injection, inform your doctor — cumulative aminoglycoside exposure requires monitoring for hearing and kidney effects |
| Systemic corticosteroids (e.g., Prednisolone tablets) | If the patient is already taking oral or injected steroids, inform your doctor — combined steroid exposure should be monitored |
| Immunosuppressant medicines | Dexamethasone may further reduce immune response — inform your doctor if taking any immunosuppressant medicines |
| Known allergy to aminoglycoside antibiotics | Do not use Tobramycin-containing drops if the patient has a known systemic allergy to any aminoglycoside antibiotic |
Always inform your doctor about all medicines, ear preparations, vitamins, or supplements you are currently using.
Storage Instructions
- Store below 25°C in a cool, dry place
- Keep away from direct sunlight and moisture
- Do not refrigerate or freeze the ear drops
- Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
- Do not use after the expiry date printed on the bottle or outer box
- Keep the bottle tightly closed after each use to prevent contamination
- Discard the bottle 4 weeks after first opening — do not use beyond this period even if liquid remains
- Do not use if the solution appears cloudy, discoloured, or contains visible particles
Frequently Asked Questions (FAQs)
What is Dexatob Ear Drops used for?
Dexatob Ear Drops are used to treat bacterial infections of the outer ear canal — such as otitis externa and swimmer's ear — where both infection and inflammation are present. Tobramycin kills the bacteria causing the infection while Dexamethasone rapidly reduces the swelling, redness, pain, and itching caused by the inflammatory response.
What is the difference between Dexatob Ear Drops and plain antibiotic ear drops?
Plain antibiotic ear drops — such as those containing only Neomycin or Polymyxin — only treat the bacterial infection without addressing inflammation. Dexatob combines Tobramycin with the steroid Dexamethasone, which also reduces swelling, redness, and pain in the ear canal. This makes Dexatob more suitable when significant inflammation is present alongside the infection — which is the case in most outer ear infections.
Why must I not use Dexatob Ear Drops if my eardrum is perforated?
The eardrum is a protective barrier between the outer ear canal and the sensitive structures of the middle and inner ear. If the eardrum has a hole or tear, ear drops can pass through into the middle ear. Tobramycin reaching the inner ear can damage the delicate hair cells responsible for hearing and balance, potentially causing permanent hearing loss or balance problems. Your doctor must always examine your ear and confirm the eardrum is intact before prescribing any antibiotic ear drops.
How quickly will Dexatob Ear Drops work?
Most patients notice a reduction in pain, itching, and swelling within 2 to 3 days of starting treatment as the steroid Dexamethasone reduces inflammation. The antibiotic Tobramycin needs the full course to clear the bacterial infection completely — which is why it is essential to complete all 7 days of treatment even if you feel better sooner. Stopping early risks the infection returning and potentially becoming harder to treat.
Can Dexatob Ear Drops be used for a middle ear infection?
No. Dexatob Ear Drops are specifically for infections of the outer ear canal only. Middle ear infections — which occur behind the eardrum — are a completely different condition and require different treatment, usually oral antibiotics prescribed by a doctor. Using ear drops for a middle ear infection will not reach the site of infection and will not be effective. If you have ear pain with fever, hearing loss, or discharge from behind the eardrum, see your doctor immediately.
Can I use Dexatob Ear Drops if I have a fungal ear infection?
No. Dexatob Ear Drops must not be used for fungal ear infections. The Dexamethasone steroid in these drops suppresses the immune response, which can allow fungal infections to grow worse. Fungal ear infections require specific antifungal ear drops — consult your doctor who will examine your ear and prescribe the correct treatment for the type of infection present.
⚕️ Medical Disclaimer: This product description is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified doctor or pharmacist before starting, stopping, or changing any medication. This product is a prescription medicine — it must only be used under the supervision of a licensed healthcare professional.
DRAP Registered | Prescription Required (Rx) | For external use in the ear only | Do not use if eardrum is perforated