FOR UK HEALTHCARE PROFESSIONALS

Lorente et al (2014)2

Non-inferiority study comparing the efficacy and safety of ciprofloxacin otic solution 0.2% to polymyxin B-neomycin-hydrocortisone (PNH) otic solution in the treatment of acute diffuse otitis externa in children, adolescents and adults. 630 patients were randomised to 7 days treatment with either Cetraxal solution 0.25ml twice-daily or PNH three times daily.

✓ Ciprofloxacin was found to be non-inferior to PNH (polymyxin-b-neomycin-hydrocortisone).
✓ Ciprofloxacin was well tolerated with only mild adverse events recorded: ear pruritus (0.9%), headache (0.6%) and application site pain (0.6%).

Cetraxal showed non-inferior efficacy to neomycin-based treatment, PNH

Lorente et al (2014)2

Randomised, double-blind, parallel-group clinical trial comparing the efficacy of ciprofloxacin otic solution 0.3% (4-6 drops every 8 hours for 8 days) with ciprofloxacin 0.3% and fluocinolone acetonide 0.025% otic solution (4-6 drops every 8 hours for 8 days) in the treatment of diffuse otitis externa.

✓ Reduction in intensity of oedema and otorrhea in patients receiving ciprofloxacin + fluocinolone vs ciprofloxacin alone.
✓ Comparable resolution of otalgia between ciprofloxacin and ciprofloxacin + fluocinolone.
✓ Both treatments were well tolerated.

Use of steroid may be reserved for more complicated cases of AOE with swelling or known tympanic membrane perforation.