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Treatment of acute otitis externa in adult & paed ≥1 yr due to susceptible strains of Pseudomonas aeruginosa Staphylococcus aureus & Proteus mirabilis.


Hypersensitivity to hydrocortisone, ciprofloxacin or quinolones. Perforated tympanic membrane. Viral infections of the external canal including varicella & herpes simplex infections.

Adverse reactions:

Headache, pruritus; migraine, hypesthesia, paresthesia, fungal dermatitis, cough, rash, urticaria & alopecia.


As with some other quinolones, concurrent administration of ciprofloxacin with theophylline may lead to elevated serum concentrations of theophylline and prolongation of its elimination half-life. This may result in increased risk of theophylline-related adverse reactions. Concurrent administration of a quinolone, including ciprofloxacin, with magnesium / aluminium antacids, sucralfate or products containing calcium, iron, or zinc may substantially decrease its absorption, resulting in serum and urine levels considerably lower than desired. Quinolones, including ciprofloxacin, have been reported to enhance the effects of the oral anticoagulant warfarin or its derivatives. Renal tubular transport of methotrexate may be inhibited by concomitant administration of ciprofloxacin potentially leading to increased plasma levels of methotrexate. This might increase the risk of methotrexate associated toxic reactions. Therefore, patients under methotrexate therapy should be carefully monitored when concomitant ciprofloxacin therapy is indicated. Metoclopramide significantly accelerates the absorption of oral ciprofloxacin resulting in shorter time to reach maximum plasma concentrations. No significant effect was observed on the bioavailability of ciprofloxacin.


Care should be taken for therapy wit Ciprofloxacin to pregnant women , nursing women and children below 18 years of age. Ciprofloxacin may cause convulsions, toxic psychosis, C.N.S events including dizziness , confusion , tremors, hallucination and depression . The drug is discontinued and appropriate therapy instituted. Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia which is the cause of antibiotic associated colitis. Ciprofloxacin has not been shown to be effective in the treatment of syphilis. Ciprofloxacin may cause rarely crystaluria because human urine is acidic, but it is more frequent in animals because it is alkaline and therefore alkalinity of the patients urine receiving Ciprofloxacin is avoided and patients should be highly hydrated to avoid concentration of the urine Phototoxicty represented by sun burn is observed in patients receiving quinolone therapy while they are exposed to direct sun light. Ciprofloxacin should not be taken concurrently with milk while dietary calcium will affect absorption of Ciprofloxacin.


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Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

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Samir Moussa M.D. ENT Specialist

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Dr. Faisal Dibsi

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Dr . Dirar Abboud Hepatologist – Gastroenterologist

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