Ofloxacin vs Ciprodex – which is better?
Introduction
An ear infection is an inflammation of the ear, typically caused by bacteria. There are three main types of ear infections, including:
- outer ear infection – it is also referred to as otitis externa or swimmer’s ear. The outer ear is that part of the ear that extends out from your eardrum to the outside of the head. Symptoms include – swollen, red, tender, and painful ear;
- middle ear infection – it is also referred to as otitis media. The middle ear is the area right behind the eardrum. Otitis media is caused by fluid trapped behind the eardrum. Symptoms include – a sense of fullness in your ear, earache, trouble hearing, fever, and fluid drainage from the affected ear;
- inner ear infection – it is actually an inflammation of the labyrinthitis. Symptoms include – vomiting, ear pain, nausea, and dizziness.
Symptoms
Common symptoms of ear infections include:
- hearing loss;
- mild pain or discomfort inside the ear;
- pus-like ear drainage;
- tinnitus;
- fussiness in young infants;
- a feeling of pressure inside the ear which persists.
Causes
An ear infection is typically caused by bacteria. Here is a comparison of two medications that are used for the treatment of ear infections:
Ofloxacin
It belongs to a class of medications called quinolone antibiotics.
It has a potent bactericidal activity and has been clinically utilized since the late 1980s.
Ciprodex
It contains a combination of:
- dexamethasone – it is an anti-inflammatory corticosteroid;
- ciprofloxacin – it is a quinolone-type antibiotic.
Uses
Ofloxacin is used to treat bacterial infections which cause:
- infections of the prostate;
- urinary tract infections;
- ear infections;
- skin infections;
- gonorrhea;
- chlamydia;
- pneumonia;
- bronchitis.
Ciprodex is used to treat outer ear infections (also known as otitis externa) in children and adults and middle ear infections in children with ear tubes.
Mechanism of Action
Ofloxacin works by killing the pathogenic bacteria and by blocking the bacteria from repairing and reproducing themselves.
Ciprodex’s mechanism of action is as follows:
- dexamethasone – controls the biosynthesis of leukotrienes and prostaglandins by inhibiting the release of arachidonic acid;
- ciprofloxacin – it works by inhibiting the enzymes topoisomerase II and topoisomerase IV.
Side Effects
Ofloxacin
Possible side effects may include:
- a runny nose;
- abdominal pain;
- excessive air or gas in the stomach;
- anxiety;
- change in taste;
- black or tarry stools;
- joint pain;
- confusion;
- decreased appetite;
- diarrhea;
- painful urination;
- fever.
Ciprodex
Common side effects can include:
- mild skin itching;
- mild diarrhea;
- vaginal discharge or itching;
- changes in the sense of taste;
- fast or pounding heartbeat;
- dizziness;
- vomiting;
- headache;
- nausea.
Stop using this medication and call your healthcare provider at once if you have a serious side effects like:
- a red or purple skin rash that spreads, particularly in the upper body and face;
- diarrhea which is bloody or watery;
- skin pain;
- burning in your eyes;
- seizure (convulsions);
- swelling in your tongue or face;
- feeling light-headed;
- a sore throat;
- unusual thoughts or behavior;
- severe dizziness;
- confusion;
- urinating not at all or less than usual;
- nightmares;
- fever;
- fainting;
- insomnia;
- tingly feeling in your hands or feet;
- tremors;
- burning pain;
- feeling restless;
- swollen glands;
- jaundice (yellowing of the skin or eyes);
- anxiety;
- weakness;
- hallucinations;
- dark colored urine;
- loss of movement in any of your joints;
- pale skin;
- easy bruising or bleeding.
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Dosage
The usual recommended dose of Ofloxacin is 300 mg orally two times per day.
The usual recommended dose of Ciprodex is 4 drops that are instilled into the affected ear two times per day for a week.
Warnings & Precautions
Ofloxacin
- do not drive or operate heavy machinery;
- do not use this medication if you are allergic to any of its ingredients;
- avoid consuming dairy products while using this medication;
- do not use it if you have kidney problems.
Ciprodex
Do not use this medication in viral infections of the external canal, like – fungal otic infections and herpes simplex infections. Also, the medication is contraindicated in individuals with a history of hypersensitivity to dexamethasone.
Drug Interactions
Ofloxacin may interact in a negative way with the following medications:
- Cyclosporine;
- Cisapride;
- Didanosine;
- Droperidol (an antidopaminergic drug that is used as an antiemetic and as an antipsychotic);
- Probenecid;
- Budesonide;
- antacids;
- Theophylline;
- Cimetidine;
- Sucralfate (a medication mainly used to treat active duodenal ulcers);
- Naproxen;
- Oxymetazoline;
- ibuprofen.
There are no known drug interactions associated with Ciprodex.
Alcohol
Concomitant intake of alcoholic beverages with ofloxacin may increase the risk of sedative effects.
There may be a negative interaction between alcohol and Ciprodex.
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Is It Safe During Pregnancy or Breastfeeding?
Ofloxacin
Tell your healthcare provider if you are pregnant before taking this antibiotic since there are no studies regarding its safe use during pregnancy. However, it is not recommended to breastfeed while you are using this antibiotic.
Ciprodex
It is not known if this medication will harm your developing fetus. Therefore, it should be used during pregnancy only if the benefit outweighs the risk to the baby. It is known that this medication can pass into your breast milk and may harm your breastfed infant.
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Bottom Line – Ofloxacin vs Ciprodex
Ofloxacin belongs to a group of antibiotics called fluoroquinolones which work by killing the pathogenic bacteria which are causing an infection. This prescription medication is used to treat certain bacterial infections, such as – bronchitis (an inflammation of the lining of the bronchial tubes), pneumonia, and infections of the urinary tract, bladder, reproductive organs, skin, and prostate as well as bacterial infections of the eyes and ears.
Ciprodex is a prescription ear drop that is used to treat:
- otitis externa in adults and in children at least 6 months of age;
- acute otitis media in children at least 6 months of age who have a tube in their eardrum.
Infections of the middle ear and external auditory canal (when not severe) should be treated with topical preparations, according to the American Academy of Otolaryngology-Head and Neck Surgery. The advantages of topical therapy include:
- lack of potential for ototoxicity;
- less likelihood of certain strains of microorganisms to develop a resistance;
- decreased risk of systemic side effects;
- excellent efficacy.
According to a 1992 study that was done at the Department of Pharmacy Services, Hartford Hospital, both drugs are effective as a treatment for infections due to gram-negative organisms, however, ofloxacin is also appropriate in the treatment of:
- infections in people concomitantly receiving theophylline (a methylxanthine drug that is used in therapy for asthma and chronic obstructive pulmonary disease);
- urethritis, especially when C. trachomatis is suspected or documented;
- infections where both staphylococci or S. pneumoniae and aerobic gram-negative rods are suspected or documented.
Sources https://www.ncbi.nlm.nih.gov/pubmed/6596877 https://bjo.bmj.com/content/bjophthalmol/75/11/675.full.pdf