From the Research
For tympanic membrane (TM) perforation, ofloxacin otic solution 0.3% is typically dosed as 5-10 drops in the affected ear twice daily for 7-10 days, as supported by the most recent and highest quality study 1. The exact number of drops may vary based on the size of the perforation and severity of infection. Before administration, the ear should be gently cleaned of any drainage, and the patient should lie with the affected ear upward for 5 minutes after instillation to ensure proper distribution. Ofloxacin is preferred for TM perforations because it is non-ototoxic, unlike some other topical antibiotics that can damage inner ear structures, as noted in a study from 2. This medication works by inhibiting bacterial DNA gyrase, preventing bacterial replication, and is effective against common pathogens that cause otitis media and externa. Some key points to consider when treating TM perforation include:
- Keeping the ear dry during the treatment period to prevent further infection, as emphasized in 3 and 4.
- Completing the full course of treatment even if symptoms improve earlier.
- Monitoring for signs of worsening infection or lack of improvement, in which case medical reassessment is recommended, as suggested in 5 and 4. The use of ofloxacin otic drops has been shown to shorten the closure time and improve the closure rate of traumatic TMPs, particularly large perforations, without affecting hearing improvement or increasing the rate of middle ear infection, as found in the study 1.