Ofloxacin Otic Solution Dosing for 94-Year-Old with Otitis Externa
For a 94-year-old outpatient with otitis externa, the recommended sig for ofloxacin otic solution is: "Instill 10 drops into affected ear(s) once daily for seven days." 1
Dosage Details
According to the FDA-approved labeling for ofloxacin otic solution:
- For patients 13 years and older (which includes our 94-year-old patient): 10 drops (0.5 mL, 1.5 mg ofloxacin) instilled into the affected ear once daily for seven days 1
- The solution should be warmed by holding the bottle in the hand for one or two minutes before administration to prevent dizziness 1
Administration Instructions
The following administration instructions should be provided to the patient or caregiver:
- Lie down with the affected ear facing upward
- Instill the drops into the ear canal
- Maintain this position for 5 minutes to facilitate penetration of the drops into the ear canal 2, 1
- If both ears are affected, repeat the procedure for the opposite ear
Important Patient Education Points
- Complete the full 7-day course of treatment even if symptoms improve before completion 3
- Avoid inserting anything into the ear canal, including cotton-tipped swabs 2
- Cover the ear canal opening with an earplug or cotton (with petroleum jelly) before showering or hair washing 2
- Avoid swimming or other water activities during treatment 2
- Pain relief may take approximately 48 hours; pain medication may be needed until the eardrops begin working 2
Special Considerations for Elderly Patients
- If possible, have someone else administer the drops 2
- The once-daily dosing regimen offers better adherence compared to more frequent dosing schedules, which is particularly beneficial for elderly patients 4, 5
- Ofloxacin otic solution has minimal systemic absorption, making it a safe option for elderly patients 6
Monitoring and Follow-up
- If symptoms persist beyond 7 days, the patient should contact their healthcare provider 2
- Treatment may be extended for up to an additional 7 days if needed 2
- Watch for side effects such as local rash, itching, irritation, or discomfort, though these are rare 2
Efficacy and Safety
Ofloxacin otic solution has demonstrated high clinical cure rates (>80% in adults) 7 and has been shown to be effective with once-daily dosing for 7 days, with a 91% cure rate in clinical studies 8. The American Academy of Otolaryngology-Head and Neck Surgery recommends fluoroquinolone ear drops, such as ofloxacin, as first-line treatment for acute otitis externa 3.