From the FDA Drug Label
Ciprofloxacin otic solution, 0.2% should be given 2 times each day (about 12 hours apart) in each infected ear.
The recommended dose of ciprofloxacin for otorrhoea associated with grommets is 0.2% otic solution, 2 times a day (about 12 hours apart) in each infected ear 1.
- Key points:
- Dosage: 0.2% otic solution
- Frequency: 2 times a day
- Administration: in each infected ear
- Important consideration: The patient should be advised to follow the directions for use as prescribed, even if the symptoms improve.
From the Research
For grommet-associated otorrhea, ciprofloxacin ear drops (0.3%) are typically recommended at a dose of 3-4 drops into the affected ear twice daily for 7-10 days, as supported by the most recent and highest quality study 2.
Key Considerations
- The dose and duration of ciprofloxacin ear drops may vary depending on the patient's age and response to treatment.
- It is essential to warm the drops to room temperature before administration to prevent dizziness, especially in children.
- When administering, the patient should lie with the affected ear upward, and the drops should be instilled and maintained in this position for 3-5 minutes to allow proper distribution.
- Gently pulling the ear lobe backward and upward for adults (or downward and backward for children) can help straighten the ear canal.
Rationale
- Ciprofloxacin is effective against common pathogens causing otorrhea, including Pseudomonas aeruginosa, while minimizing systemic absorption 3.
- Topical treatment is preferred over oral antibiotics as it delivers a higher concentration of medication directly to the infection site with fewer systemic side effects.
- The most recent study 2 found that intraoperative topical ciprofloxacin was effective at preventing early postoperative otorrhea, and a prolonged course was effective at preventing ventilation tube obstruction.
Additional Guidance
- If symptoms persist beyond 10 days or worsen, medical reassessment is necessary to determine the best course of action.
- Future studies should seek to clarify whether particular subgroups of patients benefit more from prophylactic topical antibiotics and model for cost-effectiveness 2.