Vol.6 Issue 1
Otitis media

I am a pediatric nurse practitioner and each week I treat several children for acute otitis media.  Several mothers have asked me about the effectiveness of garlic ear drops to manage or prevent recurrent infections.  Are there any data to support the safety and efficacy of these drops?

Many herbalists have recommended the use of garlic ear drops to reduce pain and shorten the duration of acute otitis media. Most garlic ear drop preparations also contain mullein, a plant from the genus Verbascum. Both garlic and mullein have been shown to have antibacterial activity in vitro (1-4), although clinical trials to determine antimicrobial activity in vivo have not been conducted. To date there have been two published randomized clinical trials to test the efficacy of naturopathic ear drops that contained garlic and mullein to reduce pain in pediatric otitis media (5-6). When compared to
anesthetic ear drops, the naturopathic drops were equally effective in reducing ear pain in children not receiving concomitant antibiotic therapy (5). Because antibiotics are commonly prescribed to manage acute otitis media, the investigators conducted a follow-up study to compare the products’ analgesia efficacy in children who were randomized to receive either amoxicillin or placebo (6). The findings showed that the naturopathic ear drops were associated with greater pain relief after three days of treatment, irrespective of antibiotic treatment. Neither clinical trial measured duration of infection nor changes in tympanic membrane appearance. While data on the safety of mullein are lacking, there have been two case reports of skin burns occurring in children who were treated with topical garlic (7-8), however, no adverse events were reported in either ear drop trial.  Additional trials are needed to determine the role of garlic ear drops in the management of acute otitis media.

Barbara Swanson, DNSc, RN, ACRN
Associate Professor
Rush University College of Nursing
Chicago, Illinois

1.         Bakri IM, Douglas CW. Inhibitory effect of garlic extract on oral bacteria. Arch Oral Biol 2005;50:645-651.

2.         Iwalokun BA, Ogunledun A, Ogbolu DO, Bamiro SB, Jimi-Omojola J. In vitro antimicrobial properties of aqueous garlic extract against multi-drug resistant bacteria and Candida species in Nigeria. J Med Food 2004:7:327-333.

3.         Sasaki J, Kita T, Ishita K, et al. Antibacterial activity of garlic powder against Escherichia coli O-157. J Nutr Sci Vitaminol 1999;45:785-790.

4.         Turker AU, Camper ND. Biological activity of common mullein, a medicinal plant. J Ethonopharmacol 2002;82:117-125.

5.         Sarrell EM, Mandelberg A, Cohen HA. Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media. Arch Pediatr Adolesc Med 2001;155:796-799.

6.         Sarrell EM, Cohen HA, Kahan E. Naturopathic treatment for ear pain in children. Pediatrics 2003;111:574-579.

7.         Garty BZ. Garlic burns. Pediatrics 1993;91:658-659.

8.         Parish RA, McIntire S, Heimbach DM. Garlic burns: A naturopathic remedy gone awry. Pediatr Emerg Care 1897;3:258-260.