Pharmacokinetics of CIPRODEX® otic in pediatric and adolescent patients

Spektor, Zorik; Jasek, Mark C; Jasheway, D.; Dahlin, David C.; Kay, David J.; Mitchell, Ron B.; Faulkner, Robert; Wall, G. Michael

doi:10.1016/j.ijporl.2007.09.017

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…37 Thus, mometasone furoate is less likely to cause systemic side effects compared to older steroids with lower binding affinity and higher systemic absorption rates, such as flunisolide, beclomethasone, triamcinolone, and budesonide. Dexamethasone, on the other hand, has one of the lowest affinities for glucocorticoid receptors, and preparations of dexamethasone in otic drops have higher dosages of steroid (~140 μg per drop in Ciprodex 38 vs 50 μg of mometasone in Nasonex 39 ).…”

Section: Discussionmentioning

confidence: 99%

Off-Label Use of Ciprofloxacin/Dexamethasone Drops in the Pediatric Upper Airway: Case Presentation and Review of Adverse Effects

Ben-Dov

Yang

April

2022

Ann Otol Rhinol Laryngol

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Objective: This report describes a new observation of hyperglycemia in a child with Type 1 diabetes after off-label use of otic ciprofloxacin/dexamethasone drops in the nasal passage and reviews previous reports of adverse endocrine effects from intranasal corticosteroids in pediatric patients. Methods: We describe the clinical case and conducted a literature review of MEDLINE (PubMed) and EMBASE. Results: A 9-month-old female with a history of Type 1 diabetes who underwent unilateral choanal atresia repair was started on 1 week of ciprofloxacin 0.3%/dexamethasone 0.1% otic drops twice a day for choanal obstruction with granulation tissue. While the patient’s airway patency improved, average daily blood glucose increases by 40 to 50 points were noted on the patient’s continuous glucose monitor. The hyperglycemia resolved within 2 days after switching to mometasone furoate 0.05% spray. We also review 21 pediatric otolaryngology cases of iatrogenic Cushing’s syndrome associated with on- and off-label use of topical steroid suspensions in the airway. Patients ranged from 3 months to 16 years in age and used doses of 50 μg/day to 2 mg/day. Conclusion: This is the first reported pediatric case of increased blood glucose levels associated with intranasal steroid suspensions, to the best of our knowledge. Counseling families on precise dose administration and potential endocrine disturbances is critical when prescribing these medications for off-label use in infants and small children, particularly among patients with underlying endocrine disorders such as diabetes.

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Section: Discussionmentioning

confidence: 99%

Off-Label Use of Ciprofloxacin/Dexamethasone Drops in the Pediatric Upper Airway: Case Presentation and Review of Adverse Effects

Ben-Dov

Yang

April

2022

Ann Otol Rhinol Laryngol

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“…Ciprofloxacin hydrochloride (CIP) [1-cyclopropyl-6-fluoro-1,4-dihydro-4oxo-7-(piperaziny-1-yl) quinolone-3-carboxylic acid] is a broadspectrum antibiotic [1,2] which is often used jointly with dexamethasone (DEX, an exogenous steroid) [(11β,16α)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4-diene-3,20-dione] in several anti-infective ophthalmic preparations to treat acute and sub acute conjunctivitis, keratitis and corneal ulcers caused by susceptible strains [3]. The same combination is used for the topical treatment of acute otitis media in pediatric patients with tympanostomy tubes and acute otitis externa in pediatric, adult and elderly patients [4].…”

Section: Introductionmentioning

confidence: 99%

Green method based on a flow-batch analyzer system for the simultaneous determination of ciprofloxacin and dexamethasone in pharmaceuticals using a chemometric approach

Razuc

Grünhut

Saidman

et al. 2013

Talanta

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Drug Delivery across Barriers to the Middle and Inner Ear

Zhang

et al. 2020

Adv Funct Materials

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The prevalence of ear disorders has spurred efforts to develop drug delivery systems to treat these conditions. Here, recent advances in drug delivery systems that access the ear through the tympanic membrane (TM) are reviewed. Such methods are either non-invasive (placed on the surface of the TM), or invasive (placed in the middle ear, ideally on the round window [RW]). The major hurdles to otic drug delivery are identified and highlighted the representative examples of drug delivery systems used for drug delivery across the TM to the middle and (crossing the RW also) inner ear.

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Pharmacokinetics of CIPRODEX® otic in pediatric and adolescent patients

Cited by 9 publications

References 17 publications

Off-Label Use of Ciprofloxacin/Dexamethasone Drops in the Pediatric Upper Airway: Case Presentation and Review of Adverse Effects

Off-Label Use of Ciprofloxacin/Dexamethasone Drops in the Pediatric Upper Airway: Case Presentation and Review of Adverse Effects

Green method based on a flow-batch analyzer system for the simultaneous determination of ciprofloxacin and dexamethasone in pharmaceuticals using a chemometric approach

Drug Delivery across Barriers to the Middle and Inner Ear

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