From the Guidelines
Turicella otitis ear infections should be treated with topical antibiotic therapy, specifically quinolone ear drops, as they have been shown to have superior outcomes compared to systemic oral antibiotics. The most recent and highest quality study, published in 2022 1, recommends the use of topical antibiotic eardrops, such as ofloxacin, ciprofloxacin, or ciprofloxacin-dexamethasone, for treating acute tympanostomy tube otorrhea (TTO) in children. These drops have been found to have superior clinical cure rates, bacterial eradication, and patient satisfaction compared to systemic oral antibiotics.
Key Points to Consider
- Topical antibiotic therapy avoids adverse events associated with systemic antibiotics, including dermatitis, allergic reactions, gastrointestinal upset, and potential for increased antibiotic resistance 1.
- Only topical drops approved for use with tympanostomy tubes should be prescribed to avoid potential ototoxicity from aminoglycoside-containing eardrops 1.
- Caregivers should be advised to limit topical therapy to a single course of no more than 10 days and to clean the ear canal of any debris or discharge before administering the drops 1.
- Children who fail topical therapy may require further cleaning of the ear canal or suctioning of the tube lumen to facilitate drug delivery, and culture of persistent drainage from the ear canal may help target future therapy 1.
Treatment Recommendations
- Ciprofloxacin ear drops (0.3%) administered as 4 drops in the affected ear twice daily for 7-10 days are a suitable treatment option for Turicella otitis ear infections.
- Before applying ear drops, the ear canal should be gently cleaned of any discharge to allow the medication to reach the infection site.
- Patients should keep the ear dry during treatment by avoiding swimming and using earplugs during showers.
- Pain management with acetaminophen or ibuprofen is recommended as needed.
From the FDA Drug Label
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta-lactamase producing strains) or Moraxella catarrhalis (including beta-lactamase producing strains) The treatment for Turicella (otitis) ear infection is ceftriaxone (IM), as it is indicated for the treatment of Acute Bacterial Otitis Media caused by susceptible organisms, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2.
- Key points:
- Ceftriaxone for injection USP is indicated for the treatment of Acute Bacterial Otitis Media
- The treatment is effective against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis
- A single dose of ceftriaxone may be used, but the clinical cure rate should be balanced against the potential advantages of parenteral therapy 2.
From the Research
Treatment for Turicella (Otitis) Ear Infection
- The treatment for Turicella otitidis ear infection involves the use of broad-spectrum intravenous antibiotics, as seen in a case study where a 71-year-old male was treated with broad-spectrum intravenous antibiotics and device explantation 3.
- For acute otitis media, the optimal approach to treatment requires early, efficacious, and practical therapy, with amoxicillin recommended as the first-line agent to treat uncomplicated AOM 4.
- Other recommended antimicrobial agents for clinical treatment failures after 3 days of amoxicillin include oral amoxicillin/clavulanate, cefuroxime axetil, cefprozil, cefpodoxime proxetil, and intramuscular (i.m.) ceftriaxone 4.
- Studies have compared the efficacy and safety of azithromycin versus amoxicillin/clavulanate for the management of acute otitis media in children, with results showing that azithromycin is comparable to amoxicillin/clavulanate in achieving clinical cure or improvement and presumed eradication of baseline pathogens 5, 6, 7.
- Azithromycin has been found to be better tolerated and associated with fewer relapses than amoxicillin/clavulanate therapy 6.
- A single-dose extended-release azithromycin has been shown to provide near equivalent effectiveness to a 10-day regimen of amoxicillin/clavulanate in the treatment of children with acute otitis media 7.
Antibiotic Options
- Amoxicillin: recommended as the first-line agent to treat uncomplicated AOM 4.
- Amoxicillin/clavulanate: recommended for clinical treatment failures after 3 days of amoxicillin 4.
- Azithromycin: comparable to amoxicillin/clavulanate in achieving clinical cure or improvement and presumed eradication of baseline pathogens 5, 6, 7.
- Cefuroxime axetil, cefprozil, cefpodoxime proxetil, and intramuscular (i.m.) ceftriaxone: recommended for clinical treatment failures after 3 days of amoxicillin 4.