title: N-Acetylcysteine as an adjunct for refractory ear infections.
abstract: 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.
authors: California Ear Institute in E. Palo Alto, E. Palo Alto, California, USA. choewt@yahoo.com
authors: Won-Taek
authors: WT
authors: Choe
authors: Michael T
authors: MT
authors: Murray
authors: Katrina R
authors: KR
authors: Stidham
authors: Joseph B
authors: JB
authors: Roberson
mesh_terms: 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
chemical_list: D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D004338:Drug Combinations; D019999:Pharmaceutical Solutions; D002939:Ciprofloxacin; D003907:Dexamethasone; D000111:Acetylcysteine