Topical Fluoroquinolone Antibiotic Pregnancy: Compatible — negligible systemic absorption from otic route

Ciprofloxacin Ear Drops

Brand names: Cetraxal, Ciloxan Otic

Adult dose

Dose: Otitis externa: 2–3 drops (0.5 mg/drop) into affected ear BD for 7 days. Otitis media (with perforated drum or tubes): same regimen.

Route: Topical otic

Frequency: BD

Max: 6 drops/day

Safe with perforated tympanic membrane (unlike aminoglycoside ear drops). For bacterial otitis externa or AOM with tympanostomy tubes. Warm drops to body temperature before instilling.

Paediatric dose

Route: Otic

Frequency: BD

Max: 3 drops per instillation

Concentration: 0.2%–0.3% solution drops/ml

Children ≥1 year: 2–3 drops BD for 7 days (otitis externa). Safe through tympanostomy tubes. Warm to body temperature.

Dose adjustments

Renal

N/A (topical)

Hepatic

N/A

Clinical pearls

SAFE with perforated TM — unlike neomycin/gentamicin ear drops which are ototoxic with perforation
Warm ear drops to body temperature before use (cold drops cause dizziness — caloric stimulation of labyrinth)
Positioning: lie with affected ear up for 2 min after instillation to keep drops in ear canal
NICE NG91: topical treatment preferred for acute otitis externa; ciprofloxacin drops first-line if treatment needed

Contraindications

Fungal ear infections
Viral infections (herpes)

Side effects

Local burning/stinging
Pruritus
Ear discomfort
Taste perversion (via Eustachian tube)

Interactions

Minimal systemic absorption — no clinically significant interactions

Monitoring

Symptom resolution at 7 days
Signs of fungal superinfection (if no improvement)

Reference: BNFc; BNF; NICE NG91 Otitis Externa; SIGN Otitis Media Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways