Ciprodex Dosing for 17-Year-Old with Otitis Externa
For a 17-year-old with otitis externa, administer 3-4 drops of Ciprodex (ciprofloxacin 0.3%/dexamethasone 0.1%) into the affected ear twice daily (approximately 12 hours apart) for 7 days. 1
Specific Dosing Instructions
Drop Administration
- Instill 3-4 drops into the ear canal, enough to fill it completely 2, 1
- Administer twice daily, approximately 12 hours apart 1
- Continue treatment for at least 7 days, even if symptoms improve sooner, to prevent relapse 3, 2
Proper Administration Technique
- Warm the container in hands for at least one minute before use to minimize dizziness from instilling cold solution 1
- Have the patient lie down with the affected ear facing upward 2, 1
- After instilling drops, patient should remain in this position for 3-5 minutes to allow adequate penetration 2
- Gently press the tragus in and out (tragal pumping) to help distribute the drops and eliminate trapped air 3, 2
- After administration, sit up and wipe off any excess drops 2, 1
Treatment Duration and Expected Response
- Most patients feel better within 48-72 hours and have minimal or no symptoms by 7 days 3, 2
- If symptoms persist beyond 7 days, notify the physician and continue drops until symptoms resolve for a maximum of 7 additional days 3
- The clinical cure rate with Ciprodex is approximately 90.9% at test-of-cure (Day 18) 4
Important Precautions During Treatment
Activities to Avoid
- Do not insert anything into the ear canal, including cotton-tipped swabs 3, 2
- Avoid scratching or touching the ear 3, 2
- Keep the ear dry while using ear drops 2
- Cover the ear canal opening with an earplug or cotton with petroleum jelly before showering or hair washing 3, 2
Pain Management
- Oral pain medication is especially important during the first few days until the eardrops begin working 3, 2
- Pain-relieving (anesthetic) eardrops are not recommended as they can mask symptoms of delayed response to therapy 3, 2
Special Considerations
If Ear Canal is Obstructed
- The ear canal should be cleared of inflammatory debris or obstructing cerumen before drop administration 3
- If drops don't easily run into the ear canal, a wick may need to be placed by the clinician to facilitate medication delivery 3, 2
- If a wick is placed and falls out on its own, this is a good sign indicating reduced inflammation; do not remove it yourself unless instructed 2
Safety Profile
- Ciprodex is generally safe and well tolerated in both pediatric and adult patients 4
- Common adverse events are mild and include ear pain (5.1% in clinical trials) 5
- If the patient tastes the eardrops, it may indicate a tympanic membrane perforation—inform the physician 3, 1