From the Guidelines
Cipro-dex ear drops should be prescribed for ear ache with exam findings of cloudy tympanic membrane or air bubbles behind the membrane only if there is a tympanostomy tube in place, as indicated by the presence of visible drainage or discharge from the ear canal. In the context of a child with a tympanostomy tube, the best treatment for an ear infection with visible drainage is antibiotic ear drops alone, such as ofloxacin or ciprofloxacin-dexamethasone, as stated in the clinical practice guideline: tympanostomy tubes in children 1. The treatment involves placing the drops in the ear canal two times a day for up to 10 days. Key considerations include:
- Removing ear drainage with a cotton-tipped swab dipped in hydrogen peroxide or warm water, a cotton ball to absorb drainage, or gently suctioning with an infant nasal aspirator.
- Preventing water entry into the ear canal during bathing or hair washing by using a piece of cotton saturated with Vaseline to cover the opening.
- Avoiding yeast infections of the ear canal by not using antibiotic eardrops frequently or more than 10 days at a time. However, if there is no tympanostomy tube or no visible drainage, the treatment approach may differ, prioritizing oral antibiotics or watchful waiting, depending on the clinical assessment 1. Pain management with acetaminophen or ibuprofen is also crucial in the initial treatment phase. It's essential to follow the specific guidelines and recommendations based on the presence of a tympanostomy tube and the clinical presentation of the ear infection, as outlined in the clinical practice guideline 1.
From the Research
Ear Ache Treatment with Cipro-Dex Ear Drops
- Cipro-Dex ear drops, containing ciprofloxacin and dexamethasone, have been studied for the treatment of ear infections, including acute otitis media and otitis externa 2, 3, 4.
- A study published in 2006 found that topical ciprofloxacin/dexamethasone otic suspension was superior to oral amoxicillin/clavulanic acid suspension in children with acute otitis media with otorrhea through tympanostomy tubes, resulting in more clinical cures and earlier cessation of otorrhea with fewer adverse effects 2.
- Another study published in 2007 compared ciprofloxacin/dexamethasone with neomycin/polymyxin/hydrocortisone for otitis externa pain and found that ciprofloxacin/dexamethasone provided greater pain relief and reduced inflammation and edema 3.
- However, a review of the literature on antimicrobial treatment of ENT infections suggests that antibiotics should only be prescribed for purulent forms of otitis media in children under 2 years of age or in severe cases in older children 5.
- The use of ciprofloxacin/dexamethasone ear drops for ear ache with exam findings of cloudy tympanic membrane or air bubbles behind the membrane may be supported by the literature, but it is essential to consider the specific diagnosis and severity of the infection before prescribing 2, 4.
- A study on interventions for ear discharge associated with grommets (ventilation tubes) found limited evidence for the effectiveness of topical antibiotics, including ciprofloxacin/dexamethasone, and highlighted the need for further research 6.