There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
The FDA Drug Labels for ciprofloxacin (OTIC) do not address this question.
From the Research
Treatment for Otitis Media with Perforation using Cipro (Ciprofloxacin)
- The treatment for otitis media with perforation using Cipro (ciprofloxacin) involves the use of ciprofloxacin ear drops, which have been shown to be effective in treating chronic suppurative otitis media (CSOM) 1, 2, 3.
- Ciprofloxacin ear drops have been compared to other treatments such as tobramycin and placebo, and have been found to be at least as effective in treating CSOM 2, 3.
- The use of ciprofloxacin ear drops has also been shown to be safe and well-tolerated, with no evidence of ototoxicity 1, 2, 3.
- In some cases, oral ciprofloxacin may also be used to treat CSOM, particularly in cases where the infection is severe or there is a high risk of complications 4.
- A study comparing topical ciprofloxacin ear drops to a combination of topical and oral ciprofloxacin found that both treatments were effective, but the combination therapy had a lower recurrence rate 5.
- The advantages of using topical ciprofloxacin ear drops include the ability to deliver a high concentration of antibiotics directly to the site of infection, which can help to reduce the risk of treatment failure and the development of resistant organisms 1.