Ciprofloxacin 0.3%/dexamethasone 0.1% topical drops for the management of otic infections

Abstract

The American Academy of Otolaryngology – Head and Neck Surgery has recommended that, where possible, infections of the external auditory canal and middle ear be treated with topical preparations. The advantages of topical therapy include i) excellent efficacy; ii) decreased risk of systemic side effects; iii) less likelihood of selecting for resistant strains of microorganisms; and iv) lack of potential for ototoxicity. One advantage of topical therapy arises as a consequence of a very high concentration of antibiotic in topical preparations reaching the site of infection. Ciprofloxacin 0.3%/dexamethasone 0.1% (Ciprodex^®) is the only ototopical drop approved for use in both the middle ear and external auditory canal that combines a fluoroquinolone with a steroid. At 0.3% (3000 mcg/ml), the ciprofloxacin concentration of Ciprodex exceeds the MIC of virtually all relevant organisms by a very considerable margin. The clinical efficacy of ciprofloxacin/dexamethasone suspension has been demonstrated in several large prospective clinical trials. It has been consistently equal to or superior to comparator drugs. The authors believe that the use of topical ciprofloxacin/dexamethasone will increase as the advantages of fluoroquinolone/steroid combination therapy become more widely recognized.

Keywords::

• ciprofloxacin
• Ciprodex
• dexamethasone
• draining ear
• ear drops
• otitis externa
• otitis media
• otorrhea
• ototopical
• tympanostomy tube

Acknowledgement

The authors thank Heba Costandy for medical writing and Beverly Loyd for assistance with preparation of the manuscript.