Which medications in the drug class Antibiotics are used in the treatment of Otitis Externa?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

Antibiotics

Most cases of OE are caused by superficial bacterial infections. Accordingly, most individuals with this condition may be treated with topical antibiotic preparations. Some preparations also contain a corticosteroid ingredient. The small amount of steroid that is present in the solution can help to ease the pain and edema associated with OE.

Hydrocortisone/neomycin/polymyxin B (Cortisporin, Cortomycin)

Hydrocortisone/neomycin/polymyxin is an antibacterial and anti-inflammatory agent for otic use, available as a solution or a suspension. It is used to treat steroid-responsive inflammatory conditions for which a corticosteroid is indicated and in which bacterial infection or a risk of bacterial infection exists.

Ofloxacin otic

Otic ofloxacin is a pyridine carboxylic acid derivative with broad-spectrum effect that inhibits bacterial growth by inhibiting DNA gyrase. It is available as a 0.3% (3 mg/mL) solution.

Ciprofloxacin otic (Cetraxal)

Otic ciprofloxacin is a fluoroquinolone that inhibits bacterial synthesis (and thus growth) by inhibiting DNA gyrase. It has activity against pseudomonads, streptococci, methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, and most gram-negative organisms but has no activity against anaerobes. It is available with or without hydrocortisone. Cetraxal is an otic solution available as 14 single-use applicators containing 0.25 mL of 0.2% solution each. Ciloxan is an ophthalmic solution that may be used for OE.

Dexamethasone/tobramycin (TobraDex)

Tobramycin interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, thereby causing defects in the bacterial cell membrane. Dexamethasone decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reducing capillary permeability. TobraDex is an ophthalmic solution that may be used for OE.

Gentamicin ophthalmic (Garamycin, Gentak)

Gentamicin is an aminoglycoside antibiotic used for gram-negative bacterial coverage. It is available as an ophthalmic solution that may be used for OE. This solution is a compounded medication, with each 1 mL containing 3 mg of gentamicin sulfate and 1 mg of betamethasone sodium phosphate.

Ciprofloxacin and dexamethasone otic (Ciprodex)

Ciprofloxacin is a fluoroquinolone that inhibits bacterial DNA synthesis (and thus growth) by inhibiting DNA gyrase and topoisomerases, which are required for replication, transcription, and translation of genetic material. It has activity against pseudomonads, streptococci, MRSA, S epidermidis, and most gram-negative organisms but not against anaerobes. Dexamethasone decreases external auditory canal (EAC) inflammation by suppressing migration of PMNs and reducing capillary permeability; it also relieves pain symptoms.

This otic suspension is indicated for use in OE, as well as for use in otitis media in individuals with tympanostomy tubes.

Ciprofloxacin and hydrocortisone otic suspension (Cipro HC Otic)

Ciprofloxacin is a fluoroquinolone that inhibits bacterial DNA synthesis (and thus growth) by inhibiting DNA gyrase and topoisomerases, which are required for replication, transcription, and translation of genetic material. It has activity against pseudomonads, streptococci, MRSA, S epidermidis, and most gram-negative organisms but not against anaerobes. Hydrocortisone decreases inflammation by suppressing migration of PMNs and reducing capillary permeability.


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