From the Research
Otodex is typically dosed as 4-5 drops instilled into the affected ear(s) twice daily for 7-10 days to treat otitis externa (outer ear infection). Before application, clean and dry the external ear canal gently. Tilt the head with the affected ear facing upward, pull the ear pinna upward and backward for adults (or downward and backward for children) to straighten the ear canal, and instill the drops. Maintain this position for 1-2 minutes to allow the medication to penetrate. Otodex contains neomycin, polymyxin B (antibiotics) and dexamethasone (corticosteroid), which work together to combat bacterial infection while reducing inflammation and associated symptoms like pain, itching, and swelling. Do not use if the eardrum is perforated, and discontinue if irritation or sensitivity develops. Avoid touching the dropper tip to prevent contamination. Complete the full course of treatment even if symptoms improve before finishing to ensure complete eradication of the infection and prevent recurrence.
The most recent and highest quality study, 1, published in 2019, provides guidance on the treatment of otitis externa, emphasizing the importance of analgesia, cleansing of the external auditory canal, and the application of antiseptic and antimicrobial agents. While this study does not specifically address Otodex dosing, it highlights the effectiveness of topical antimicrobial treatments in achieving a higher cure rate than placebo, and the role of corticosteroid preparations in lessening swelling, erythema, and secretions.
Key considerations in the treatment of otitis externa include:
- Cleaning and drying the external ear canal gently before application of Otodex
- Avoiding use if the eardrum is perforated
- Discontinuing use if irritation or sensitivity develops
- Completing the full course of treatment to ensure complete eradication of the infection and prevent recurrence
- Being aware of the potential for oral antibiotics to be indicated if the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection, as noted in 1 and 2.
In terms of specific dosing, the provided evidence does not offer a clear, evidence-based alternative to the standard dosing of Otodex. Therefore, the recommended dosing of 4-5 drops twice daily for 7-10 days remains the most appropriate choice, based on the available information and the importance of following established treatment protocols for otitis externa, as discussed in 3 and 4.