Tuesday May 22, 2007


Often intensivist receive calls regarding issues which are usually not expected from critical care unit. One such situation is cerumen (ear wax) ! - Scenario taken from true instance from one of our editors' call.


Scenario: 62 year old male admitted with community acquired pneumonia and responding well with treatment. Patient continue to complaint of right ear pain. On examination patient noted to have cerumen impaction. Patient is already on broad spectrum antibiotics. You ordered cerumenex (Triethanolamine polypeptide). You received call from nurse that pharmacy substituted cerumenex with Docusate sodium or colace (stool softener) and needs your approval. What you think?


Answer: This is true that Docusate sodium is a very effective alternative to facilitate the removal of cerumen. Mechanism of action is same as for stool softener that it helps water or saline to mix with the hardened secretions and produce a softer cerumen which drained easily. Instill 1 ml and keep head to keep solution inside canal for 10 to 15 minutes and than let it drain.



References: click to get abstract/article

1. Ceruminolytic effects of docusate sodium: a randomized, controlled trial. Ann Emerg Med. 2000 Sep;36(3):228-32.

2. Docusate Sodium for Use as a Ceruminolytic Agent. Amer Fam Phys. 2001 Mar;63(5):947.

3. How does liquid docusate sodium (Colace) compare with triethanolamine polypeptide as a ceruminolytic for acute earwax removal? Journ of Fam Pract. 2000 Dec;49(12):1076.

4. Ear drops for the removal of ear wax - cochran reviews