What is the preferred first-line treatment for swimmer’s ear?

The preferred first-line treatment for swimmer's ear, also known as otitis externa, is ciprofloxacin, specifically when it is combined with a corticosteroid. Ciprofloxacin is a fluoroquinolone antibiotic that is effective against the common bacteria involved in otitis externa, particularly Pseudomonas aeruginosa. Because of its dual action in reducing inflammation and alleviating symptoms of pain and discomfort, this combination is particularly effective for treating the condition.

In contrast, the other antibiotics listed, such as amoxicillin, azithromycin, and clarithromycin, are typically not the first choices for treating swimmer's ear. Amoxicillin is primarily used for middle ear infections (otitis media) and wouldn't target the bacteria commonly associated with otitis externa as directly as ciprofloxacin. Azithromycin and clarithromycin are macrolides that are not favored for this type of infection, as they might not offer the same efficacy against the prevalent pathogens found in swimmer's ear.

Thus, the choice of ciprofloxacin aligns with clinical guidelines aimed at addressing the specific bacterial causes of swimmer's ear effectively while also managing associated symptoms through the anti-inflammatory properties of the corticosteroid component.