From the FDA Drug Label
For pediatric patients (from 6 months to 13 years old): Five drops (0.25 mL, 0.75 mg ofloxacin) instilled into the affected ear once daily for seven days. The recommended treatment guideline for a 2-year-old patient with otitis externa is to instill 5 drops of ofloxacin otic solution into the affected ear once daily for 7 days 1.
- Dosage: 5 drops (0.25 mL, 0.75 mg ofloxacin)
- Frequency: once daily
- Duration: 7 days
From the Research
For a 2-year-old with otitis externa, the most effective treatment is topical antibiotic ear drops, specifically ciprofloxacin 0.3% with fluocinolone acetonide 0.025% otic solution, 4 drops twice daily for 7 days, as it has been shown to be efficacious and safe in treating acute otitis externa 2. The primary goal of treatment is to reduce morbidity, mortality, and improve quality of life by effectively managing the infection and alleviating symptoms. Key considerations in the treatment of otitis externa include:
- Gentle cleaning of the ear canal by a healthcare provider to remove debris that may block medication penetration
- Use of topical antibiotic ear drops, such as ciprofloxacin 0.3% with fluocinolone acetonide 0.025% otic solution, to target common pathogens like Pseudomonas aeruginosa and Staphylococcus aureus
- Pain management with acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours) to ensure patient comfort
- Keeping the ear dry during treatment by avoiding swimming and using a cotton ball coated with petroleum jelly during bathing
- Potential placement of a wick by the provider if significant swelling prevents drops from reaching deeper parts of the canal Studies have shown that ciprofloxacin 0.3% with fluocinolone acetonide 0.025% otic solution is effective in treating acute otitis externa, with a therapeutic cure rate of 61.2% 2. Additionally, this treatment has been shown to be safe, with only mild or moderate adverse events reported 2. It is essential to follow up with patients if symptoms worsen or do not improve within 48-72 hours to ensure effective treatment and prevent potential complications. The use of ciprofloxacin 0.3% with fluocinolone acetonide 0.025% otic solution is supported by recent studies, including a randomized clinical trial published in 2022 2, which demonstrated its efficacy and safety in treating acute otitis externa. Other treatment options, such as ofloxacin 0.3% drops, may also be considered, but ciprofloxacin 0.3% with fluocinolone acetonide 0.025% otic solution is the most effective treatment based on current evidence 2.