What is the dosage for ofloxacin (antibiotic) ear drops for treating ear infections?

Ofloxacin Ear Drop Dosing for Bacterial Ear Infections

For ear canal infections (otitis externa), use 10 drops once daily for patients 13 years and older, or 5 drops once daily for children 6 months to 12 years, for 7 days. 1

For middle ear infections with tympanostomy tubes or perforated eardrums, use 10 drops twice daily (12 hours apart) for patients 12 years and older, or 5 drops twice daily for children 1 to 11 years, for 10 days. 1

Dosing by Condition and Age

Ear Canal Infection (Otitis Externa/"Swimmer's Ear")

• Adults and adolescents ≥13 years: 10 drops once daily for 7 days 1, 2
• Children 6 months to <13 years: 5 drops once daily for 7 days 1, 2
• Clinical cure rates of 91% are achieved with this regimen, with 68% of patients cured within 7 days 2

Middle Ear Infection (with tubes or perforated eardrum)

• Patients ≥12 years: 10 drops twice daily (approximately 12 hours apart, such as 8 AM and 8 PM) 1
• Children 1 to <12 years: 5 drops twice daily 1
• Treatment duration is typically 10 days 1
• Clinical cure rates of 75-91% are achieved in chronic suppurative otitis media 3

Critical Administration Technique

Clean the ear canal of debris or discharge before administering drops—this is essential for drug delivery to the infection site. 4, 5, 6

Step-by-Step Administration 1

1. Wash hands thoroughly with soap and water
2. Warm the bottle by holding it in your hand for 1-2 minutes
3. Clean visible discharge from the outer ear only—never insert objects into the ear canal
4. Position the patient lying on their side with the infected ear facing up
5. Instill the drops without touching the dropper tip to the ear or fingers

After Drop Installation 1

For middle ear infections (with tubes/perforation):

• Gently press the tragus (the small cartilage flap in front of the ear canal) 4 times in a pumping motion to help drops pass through the tube or perforation 1

For ear canal infections:

• Gently pull the outer ear upward and backward to straighten the canal 1

For both conditions:

• Patient must remain lying on their side for at least 5 minutes after drop installation 1

Treatment Duration and Compliance

Limit topical therapy to a single course of no more than 10 days to prevent fungal external otitis (otomycosis). 4, 5, 6

• Complete the full course even if symptoms improve earlier 1
• Most patients experience improvement within 48-72 hours 7
• If no improvement after 7 days, contact the physician 1

When Topical Therapy May Fail

Approximately 4-8% of patients require oral antibiotic rescue therapy for persistent symptoms 4, 6. Consider systemic antibiotics if: 4, 7, 6

• Infection extends beyond the ear canal
• Cellulitis of the pinna or adjacent skin develops
• Patient is immunocompromised or diabetic
• Ear drops cannot be administered effectively
• Symptoms persist or worsen despite appropriate topical therapy

Important Clinical Caveats

Ensure adequate drug delivery by cleaning the ear canal before each dose—this is the most common reason for treatment failure. 4, 5

• Tissue spears (twisted toilet paper or facial tissue) can be used to absorb discharge from the outer canal 4
• For severe canal edema preventing drop entry, an ear wick may be needed 4
• Culture persistent drainage to detect fungi or MRSA if treatment fails 4

Avoid aminoglycoside-containing drops (neomycin) in patients with non-intact tympanic membranes due to ototoxicity risk—ofloxacin is safe in this setting. 4, 3

Safety Profile

The most common adverse events are mild and include 1, 3:

• Bitter taste (5%, primarily with non-intact tympanic membranes)
• Application site discomfort (7% in otitis externa)
• Pruritus (1-2%)
• Earache (0.8%)

Ofloxacin has not demonstrated ototoxicity in clinical trials, unlike aminoglycoside-containing preparations. 3, 8

Missed Dose Management 1

For once-daily dosing (otitis externa):

• Take the missed dose as soon as remembered that same day, then resume normal schedule

For twice-daily dosing (middle ear infection):

• If almost time for the next dose, skip the missed dose
• Do not double the dose unless specifically instructed by physician