What is the recommended dose of Ciprodex (ciprofloxacin and dexamethasone) ear drops?

Recommended Dosage of Ciprodex (Ciprofloxacin and Dexamethasone) Ear Drops

The recommended dosage of Ciprodex (ciprofloxacin 0.3% and dexamethasone 0.1%) otic suspension is 4 drops instilled into the affected ear(s) twice daily for 7 days. 1, 2, 3

Administration Instructions

• Warm the container in your hands for at least one minute prior to use to minimize dizziness that may result from instilling cold solution into the ear canal 1
• Clean the ear canal of debris or discharge before administering drops, using a cotton-tipped swab with hydrogen peroxide or warm water 1
• After instilling drops, "pump" the tragus (flap of skin in front of ear canal) several times to help the drops enter the ear tube 1
• Maintain position with affected ear upward for at least one minute to facilitate penetration of the drops into the ear 4

Clinical Efficacy

• Ciprodex has demonstrated superior efficacy compared to other treatments for otitis externa and otorrhea through tympanostomy tubes 5, 2
• The combination of ciprofloxacin and dexamethasone results in:
  • Faster clinical resolution (4.0 days vs. 7.0 days) compared to oral amoxicillin/clavulanic acid 2
  • Higher clinical cure rates (85% vs. 59%) compared to oral antibiotics 2
  • Shorter time to cessation of otorrhea (4.22 days vs. 5.31 days) compared to ciprofloxacin alone 3

Advantages of Topical Therapy

• Topical therapy provides higher drug concentration at the infection site with better coverage of likely pathogens, especially Pseudomonas aeruginosa 1, 6
• Clinical cure rates with topical therapy range from 77% to 96%, significantly higher than systemic antibiotics (30% to 67%) 1
• Reduced risk of systemic side effects compared to oral antibiotics 1, 6
• Less likelihood of selecting for resistant strains of microorganisms 6

Important Considerations

• Limit topical therapy to a single course of no more than 10 days to avoid fungal (yeast) infections of the ear canal 1
• Prevent water entry into the ear canal during treatment by using cotton saturated with petroleum jelly to cover the opening during bathing or hair washing 1
• Discontinue use immediately at the first appearance of a skin rash or any other sign of hypersensitivity 4
• Common pathogens in ear tube discharge include Pseudomonas aeruginosa, Staphylococcus aureus, and typical respiratory pathogens 1, 4

Follow-up Recommendations

• If discharge continues for more than 7 days despite treatment, follow-up with an otolaryngologist is recommended 1
• Routine follow-up every 4-6 months is important to ensure tubes are functioning properly 1