Oflocet & Ciproflaxacine (Spectrum Ear Drop)

– Ofloxacin auricular (Oflocet or other), a fluoroquinolone, is authorized according to its RCP “in the treatment of purulent otorrhea: on transtympanic aerator; On recess cavity; On non-osteitic chronic otitis with open eardrum “.

This fluoroquinolone is not officially authorized in the treatment of acute otitis externa.

– However, in several clinical trials, ofloxacin and atrial ciprofloxacin were also effective in curing acute external otitis after 7 days and 2 weeks of treatment than the atrial association of an antibiotic with a corticosteroid.

We also deduce the uselessness of the local corticide in this indication.

– In a randomized trial in patients with otitis externa or chronic otitis media, the efficacy of ciprofloxacin and atrial gentamicin were similar, with no statistically significant differences

– According to Martindale, fluoroquinolones are generally active against bacteria such as Pseudomonas aeruginosa, and staphylococci. But resistance to these antibiotics is developing.

Both rifamycin and ofloxacin or ciropfloxacin are ototoxic:

Rifamycin is not, in fact, a part of ototoxic antibiotics, and may be used in cases of perforation of the eardrum , such as ofloxacin and ciprofloxacin. Let us remember the ototoxic antibiotics to be avoided in case of perforation of the eardrum are:

– Framycetin, aminoside, is no longer available in Morocco in auricular form

– Gentamicin, aminoside, is no longer available in Morocco in auricular form

– Neomycin, aminoside found in Polydexa and Antibio Synalar in association with a corticoid and polymexin B which is also ototoxic

– Polymyxin B, polypeptide found in Polydexa, Antibio Synalar and Auricularam in combination with a corticoid and oxytetracycline.

The review concludes that in practice in acute otitis externa, the absence of clinical evaluation and the spectrum of activity of rifamycin, which does not cover Pseudomonas aeruginosa, make it less useful than fluroquinolones , Ofloxacin.

The place of Rifamycin appears limited to infections resistant to treatment with fluoroquinolone, with evidence of infection with a Gram-positive bacterium, especially a staphylococcus aureus.

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