N-Acetylcysteine as an adjunct for refractory ear infections.
OBJECTIVE
To analyze the efficacy of Ciprodex otic augmented with N-acetylcysteine (NAC) against difficult ear infections.


METHODS
Subjects were selected with at least 1 month of continuous otorrhea despite at least 3 distinct medical or surgical treatments.


METHODS
Subjects received Ciprodex otic augmented with 0.5 or 2% NAC using standard dosing schemes.


METHODS
Serial audiometry and cessation of otorrhea by both history and binocular microscopy.


RESULTS
Seven subjects were included with an average of 18.4 months of continuous otorrhea despite aggressive therapy. Cessation of otorrhea was achieved in 6 of 7 subjects generally within 4 weeks of treatment. One of these 6 subjects remains on chronic suppressive therapy. The remaining subject failed because of persistent noncompliance. No subjects demonstrated ototoxicity via pretreatment and posttreatment audiometry.


CONCLUSIONS
Ciprodex otic augmented with NAC seems to have considerable efficacy against otherwise refractory ear infections. This technique may prove to be a simple and powerful option for the treatment of difficult ear infections.
Choe
Won-Taek
WT
California Ear Institute in E. Palo Alto, E. Palo Alto, California, USA. choewt@yahoo.com
Murray
Michael T
MT
Stidham
Katrina R
KR
Roberson
Joseph B
JB
D000111:Acetylcysteine / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D001299:Audiometry; D001301:Audiometry, Pure-Tone; D002648:Child; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004338:Drug Combinations; D004351:Drug Resistance; D004427:Ear Diseases / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019999:Pharmaceutical Solutions; D010865:Pilot Projects
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D004338:Drug Combinations; D019999:Pharmaceutical Solutions; D002939:Ciprofloxacin; D003907:Dexamethasone; D000111:Acetylcysteine