What volume of hydrocortisone (corticosteroid) acetic acid ear drops should be dispensed for a 10-day treatment at 5 drops in the ear, 3 times daily?

Hydrocortisone Acetic Acid Ear Drops Dispensing for 10-Day Treatment

For a 10-day treatment of 5 drops in the ear 3 times daily, 10 mL of hydrocortisone acetic acid ear drops should be dispensed.

Dosage Calculation

• Hydrocortisone 1% and acetic acid 2% otic solution is available in 10 mL plastic bottles with controlled dropper tips 1
• The FDA-approved dosing for hydrocortisone acetic acid otic solution is 3-5 drops 3-4 times daily 1
• For this prescription (5 drops TID for 10 days), we need to calculate the total volume required:
  • 5 drops × 3 times daily × 10 days = 150 drops total 1
• According to clinical practice guidelines, there are approximately 10-20 drops per mL of otic solution, depending on the nature of the liquid (solution vs suspension, viscosity, etc.) 2
• Using the conservative estimate of 15 drops per mL:
  • 150 drops ÷ 15 drops/mL = 10 mL 2

Dispensing Recommendation

• Hydrocortisone acetic acid otic solution is supplied in 10 mL bottles, which provides the exact amount needed for the full 10-day treatment course 1
• The 10 mL bottle size (NDC 51672-3007-1) is appropriate for this prescription 1

Administration Instructions

• Instruct the patient to instill 5 drops into the affected ear(s) three times daily for 10 days 1
• For optimal effectiveness, the ear canal should be clean of cerumen and debris to allow the solution to contact infected surfaces directly 1
• If needed for severe cases, a cotton wick saturated with the solution may be inserted into the ear canal for the first 24 hours to promote continuous contact with infected surfaces 1

Storage Information

• The medication should be stored at 20° to 25°C (68° to 77°F) 1
• The container should be kept tightly closed and protected from freezing 1

Clinical Considerations

• Topical therapy with hydrocortisone is preferred over systemic therapy for otitis externa, as it delivers a high concentration of medication directly to the affected area 2
• The combination of hydrocortisone (steroid) and acetic acid provides both anti-inflammatory and antimicrobial effects for treating otitis externa 2
• Studies have shown that topical steroid solutions are effective in treating external otitis, whether infected by bacteria or fungi 3

Common Pitfalls to Avoid

• Underdispensing: Providing less than 10 mL may result in incomplete treatment 1
• Improper administration: Failure to clean the ear canal of debris and cerumen can reduce effectiveness 1
• Inappropriate storage: Freezing or exposure to high temperatures can compromise medication efficacy 1