Treatment of acute otitis externa with ciprofloxacin otic 0.2% antibiotic ear solution

Abstract

Background/objectiveAn inflammation of the cutis and subcutis of the external auditory canal is a primary symptom in cases of acute otitis externa. It is usually treated locally, since this type of therapy ensures a high concentration of the drug and interacts at the site of inflammation with no systemic effects. This systematic review compares the efficacy of treatment using a ciprofloxacin 0.2% solution with other therapeutic options.MethodsAfter compiling a catalog of search terms, medical databases were searched systematically for randomized, controlled studies. This search initially yielded a total of 38 studies which were then evaluated by three independent reviewers. The number of studies was subsequently reduced to 14: six studies using a ciprofloxacin 0.2% solution, and eight studies using both 0.2% and 0.3% solutions.ResultsThe studies included in the review demonstrate the statistical equivalence between the ciprofloxacin solution (0.2%) and the reference products PNH (a combination of polymyxin B, neomycin sulfate and hydrocortisone), auriculum powder, and a ciprofloxacin foam with respect to the cure rate. The research groups consistently observed high in vitro activity of ciprofloxacin against Pseudomonas aeruginosa.ConclusionThis systematic review confirms the hypothesis of ciprofloxacin’s noninferiority in the treatment of otitis externa, in terms of the cure rate and microbiological eradication.

Ciprofloxacin plus fluocinolone acetonide versus ciprofloxacin alone in the treatment of diffuse otitis externa

“…41 In conclusion, the combination of an antibiotic (ciprofloxacin) with a corticosteroid (fluocinolone acetonide) constitutes a safe and effective treatment for diffuse otitis externa. The low rate of adverse events described for ciprofloxacin was also confirmed in the previously mentioned systematic review, including eight studies with ciprofloxacin where the low rate of side effects and the good safety profile were highlighted.…”

“…36,41 A recent systematic review of 14 randomised controlled studies in acute otitis externa, 8 of them using ciprofloxacin 0.2 and 0.3 per cent solutions, demonstrated the non-inferiority of ciprofloxacin in the treatment of otitis externa, in terms of cure rate and microbiological eradication, compared to a combination of polymyxin B, neomycin sulphate and hydrocortisone. These results are similar to the microbiological eradication rates found in two other trials with ciprofloxacin plus dexamethasone, which were 86 and 92 per cent vs 84 and 89 per cent for a combination of polymyxin B, neomycin sulphate and hydrocortisone.…”

Otomycosis in Adolescent Patients Referred to the Therapeutic Centers in Babol City, Iran

“…This disease has a local inflammation process, but it can diffuse to other tissues if suitable treatment is not started especially in immunosuppressed patients ( 6 , 7 ). Some factors such as moisture, humidity, swimming in the pool, trauma and use of hearing aids can lead people to otomycosis, although there are no exact predisposing factors to be detected after the accurate history and physical examination in some cases ( 8 - 10 ). Otomycosis exists in all ages, especially in middle ages, and also in both genders ( 5 , 11 ), but it is prevalent in swimmers and also with mixed bacterial otitis ( 12 - 14 ).…”

The Role of Topical Thymoquinone in the Treatment of Acute Otitis Externa; an Experimental Study in Rats

“…Drehobl et al [12] treated 319 external otitis patients with 0.2% ciprofloxacin for 7 days and 87.5% bacterial eradication was determined for P. aeruginosa. In the evaluation of previous studies, ciprofloxacin topical solution has been shown to have high eradication rates, such as 83.3%-95.7%, against P. aeruginosa [13] . In the ciprofloxacin-treated group in the current study, reproduction was determined in all the smear samples taken on Day 1 of the treatment, and the bacteria eradication rates were found to be 81.25%, 100%, and 100% on Days 4, 7, and 10 respectively.…”