Top 300 Pharmacy Drug Cards

CIPROFLOXACIN OTIC: Cipro HC, Cetraxal

Class: Fluoroquinolone Antibiotic

Dosage Forms. Otic Suspension: 0.2%, 0.5 mg/0.25 mL

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Common FDA Label Indication, Dosing, and Titration.

1. Otitis externa, acute: Adults and Children >1 y, 0.25 mL (entire single-use container) into affected ear(s) bid (approximately q12h) × 7 d

Off-Label Uses. None

MOA. Ciprofloxacin is a fluoroquinolone that inhibits bacterial DNA gyrase, an enzyme responsible for the unwinding of DNA for transcription and subsequent supercoiling of DNA for packaging into chromosomal subunits. It is highly active against aerobic, Gram-negative bacilli, especially Enterobacteriaceae, with MICs often <0.1 mg/L. It is also active against some strains of Pseudomonas aeruginosa and Staphylococcus spp., with an MIC of 0.5-1 mg/L. However, recent reports indicate increasing resistance to this agent in Staphylococcus aureus. It has poor activity against streptococci and anaerobes.

Drug Characteristics: Ciprofloxacin Otic

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Medication Safety Issues: Ciprofloxacin Otic

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Drug Interactions: Ciprofloxacin Otic. None known

Adverse Reactions: Ciprofloxacin Otic

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Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection. Cultures may be required if infection does not improve within 1 wk of therapy.

Toxicity Monitoring Parameters. Ear pain, local hypersensitivity reaction, secondary fungal infections.

Key Patient Counseling Points. Warm solution by holding container in hands for at least 1 min before administering. Patient should lie with affected ear upward; position should be maintained for at least 1 min after instillation; repeat in the opposite ear if necessary.

Clinical Pearls. Not for ophthalmologic use, otic use only. Ciprofloxacin otic is not approved in children under 1 y of age.