Ciprofloxacin with dexamethasone

How it works

Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV to kill common ear pathogens, while dexamethasone suppresses local inflammation, oedema and discharge.

Prescribing in practice

• It is for auricular (ear) use only and must not be injected or used in the eye, and the suspension should be warmed in the hand before instillation to avoid dizziness.
• The corticosteroid component means courses are kept short to limit the risk of secondary fungal or bacterial superinfection.
• Treatment may be reconsidered if discharge persists or recurs, as this can indicate an unresponsive or resistant organism.

Monitoring

Review clinically for resolution of discharge and for any signs of superinfection rather than by laboratory tests.

Counselling the patient

• Warm the bottle in your hands and lie with the treated ear uppermost for a few minutes after instilling the drops.
• Tell the prescriber if the discharge does not settle or comes back.

Evidence & guidelines

Topical fluoroquinolone–corticosteroid ear drops are established therapy for otorrhoea associated with grommets and for otitis externa per their SPCs and ENT guidance.