Ophthalmic ointment: Treatment of conjunctivitis caused by susceptible strains of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Haemophilus influenzae, or viridans streptococci.
Ophthalmic solution: Treatment of conjunctivitis caused by susceptible strains of S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae.
Some clinicians suggest that quinolones be reserved principally for severe bacterial conjunctivitis because of potential development of quinolone resistance, and possibly, cost considerations.
Ophthalmic solution: Treatment of keratitis (corneal ulcer) caused by susceptible strains of Pseudomonas aeruginosa, Serratia marcescens, S. aureus , S. epidermidis, S. pneumoniae, or viridans streptococci.
Some clinicians suggest that single-agent topical fluoroquinolone therapy be considered for initial treatment in patients with equivocal gram stain results on diagnostic corneal smear, presence of >1 organism, contact lens associated keratitis (suspected to be caused by gram-negative bacteria), or in settings where culture and sensitivity tests are impossible or impractical.
Bacterial Otic Infections
Ciprofloxacin-dexamethasone otic suspension: Treatment of acute otitis externa caused by susceptible strains of S. aureus or Ps. aeruginosa.
Ciprofloxacin-hydrocortisone otic suspension: Treatment of acute otitis externa caused by susceptible strains of S. aureus, Ps. aeruginosa, or Proteus mirabilis.
Ciprofloxacin-dexamethasone otic suspension: Treatment of acute otitis media caused by susceptible strains of S. aureus, S. pneumoniae, H. influenzae, Moraxella catarrhalis, or Ps. aeruginosa in patients with tympanostomy tubes.
Dosage and Administration
General
Avoid contamination of container.
Administration
Ophthalmic Administration
Apply topically to the eye as an ophthalmic ointment or solution.
Not for injection.
Remove contact lenses before administration of ophthalmic solution.
For treatment of bacterial keratitis, administer ophthalmic solution around the clock.
Otic Administration
Administered as otic suspension in fixed combination with dexamethasone or hydrocortisone.
For otic use only. Not for ophthalmic use. Not for injection.
Discard unused portion after therapy is completed.
Prior to administration, warm container in hand for 1–2 minutes before use to avoid dizziness associated with instillation of cold solution into ear canal. Shake well before use.
To administer fixed combination otic suspensions of ciprofloxacin with dexamethasone or hydrocortisone for treatment of acute otitis externa, instill drops while patient lies with affected ear upward; maintain position for 30–60 seconds to facilitate penetration of drops into ear. Repeat for opposite ear if necessary.
To administer ciprofloxacin-dexamethasone otic suspension for treatment of acute otitis media in pediatric patients with tympanostomy tubes, instill drops while patient lies with affected ear upward. Pump tragus 5 times by pushing inward to facilitate penetration of drops into middle ear; maintain position for 60 seconds. Repeat for opposite ear if necessary.
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, H. influenzae, or viridans streptococci)
Ophthalmic
Ointment: In children ≥2 years of age, apply approximately 1.27 cm (½ inch) ribbon into conjunctival sac of affected eye(s) 3 times daily for 2 days, then twice daily for next 5 days.
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae)
Ophthalmic
Solution: In children ≥1 year of age, 1 or 2 drops of 0.3% solution into conjunctival sac of affected eye(s) every 2 hours while awake for 2 days, then 1–2 drops every 4 hours while awake for next 5 days.
Keratitis
Ophthalmic
Solution: In children ≥1 year of age, 2 drops of 0.3% solution into affected eye(s) every 15 minutes for 6 hours, followed by 2 drops every 30 minutes for remainder of first day. On the second day, instill 2 drops into affected eye(s) every hour, and on days 3–14, instill 2 drops every 4 hours. May continue longer than 14 days if corneal reepithelialization is not complete.
Otic Infections
Otitis Externa (S. aureus or Ps. aeruginosa)
Otic
Ciprofloxacin-dexamethasone otic suspension: In children ≥6 months of age, 4 drops into canal of affected ear(s) twice daily for 7 days.
Otitis Externa (S. aureus, Ps. aeruginosa, or P. mirabilis)
Otic
Ciprofloxacin-hydrocortisone otic suspension: In children ≥1 year of age, 3 drops into canal of affected ear(s) twice daily for 7 days.
Otitis Media (Acute)
Otic
Ciprofloxacin-dexamethasone otic suspension: In children ≥6 months of age, 4 drops into affected ear(s) twice daily through tympanostomy tube for 7 days.
Adults
Ophthalmic Infections
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, H. influenzae, or viridans streptococci)
Ophthalmic
Ointment: Apply approximately 1.27 cm (½ inch) ribbon into conjunctival sac of affected eye(s) 3 times daily for 2 days, then twice daily for next 5 days.
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae)
Ophthalmic
Solution: 1 or 2 drops of 0.3% solution into conjunctival sac of affected eye(s) every 2 hours while awake for 2 days, then 1–2 drops every 4 hours while awake for next 5 days.
Keratitis
Ophthalmic
Solution: 2 drops of 0.3% solution into affected eye(s) every 15 minutes for 6 hours, followed by 2 drops every 30 minutes for remainder of first day. On the second day, instill 2 drops into affected eye(s) every hour, and on days 3–14, instill 2 drops every 4 hours. May continue longer than 14 days if corneal reepithelialization is not complete.
Otic Infections
Otitis Externa (S. aureus or Ps. aeruginosa)
Otic
Ciprofloxacin-dexamethasone otic suspension: 4 drops into canal of affected ear(s) twice daily for 7 days.
Otitis Externa (S. aureus, Ps. aeruginosa, or P. mirabilis)
Otic
Ciprofloxacin-hydrocortisone otic suspension: 3 drops into canal of affected ear(s) twice daily for 7 days.
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