From the Guidelines
Ofloxacin otic solution is the recommended treatment for a ruptured tympanic membrane with infection, due to its effectiveness and safety profile, as supported by the most recent and highest quality study 1.
Treatment Regimen
The typical regimen for ofloxacin otic solution is 5-10 drops of 0.3% solution in the affected ear twice daily for 7-10 days.
- Before application, the ear should be gently cleaned of any drainage.
- The patient should lie with the affected ear upward for 5 minutes after instillation to allow the medication to penetrate.
Mechanism of Action
Ofloxacin works by killing bacteria that commonly cause ear infections through inhibition of bacterial DNA gyrase.
Safety and Efficacy
It's particularly useful for perforated eardrums because, unlike some other ear drops, it is not ototoxic (harmful to inner ear structures).
Patient Instructions
During treatment, patients should:
- Avoid getting water in the ear
- Not use cotton swabs
Follow-up and Further Treatment
Most perforations heal spontaneously within 1-3 months with proper treatment of any underlying infection. If the perforation is large or doesn't heal after several months, surgical repair (tympanoplasty) may be necessary. Patients should follow up with their healthcare provider if symptoms worsen or don't improve after completing the full course of treatment, as noted in 1.
From the Research
Ruptured Tympanic Membrane Treatment with Ofloxacin
- Ofloxacin otic solution 0.3% is effective in the treatment of otitis externa and otitis media in patients with tympanic membrane perforations or tympanostomy tubes 2.
- The use of ofloxacin ear drops in patients with traumatic tympanic membrane perforation is effective in reducing healing time and increasing the rate of tympanic membrane closure 3.
- Ofloxacin otic solution 0.3% is well tolerated, with adverse events usually classified as mild to moderate, and is not associated with ototoxicity 2.
Comparison with Other Treatments
- Ofloxacin otic solution 0.3% is as effective as topical neomycin/polymixin B/hydrocortisone preparations in the treatment of otitis externa and oral amoxicillin/clavulanic acid in the treatment of otitis media in children with tympanostomy tubes 2.
- The addition of topical steroids to antibiotics, such as ciprofloxacin/dexamethasone, may increase the risk of residual tympanic membrane perforation compared to ofloxacin alone 4.
Clinical Outcomes
- Ofloxacin use in patients with traumatic tympanic membrane perforation is associated with a 13% reduction in the risk of infections, although this estimate is not statistically significant 3.
- The incidence of adverse events with ofloxacin otic solution 0.3% is similar to that with other ototopical preparations and significantly less than that with oral amoxicillin/clavulanic acid 2.