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Updated: Feb 14, 2026

Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
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Effects of Common Ear Drops on Tympanic Membrane Healing in Rats

Carolyn O Dirain1, Brendan Kosko1, Patrick J Antonelli1

  • 11 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 21, 2018
PubMed

Insights

Ciprofloxacin and dexamethasone ear drops significantly delay tympanic membrane healing in rats compared to ofloxacin. Steroids further worsen this effect, with ciprofloxacin showing greater toxicity than ofloxacin.

Area of Science:

  • Otolaryngology
  • Pharmacology
  • Wound Healing Research

Background:

  • Ototopical ciprofloxacin and dexamethasone ear drops are frequently prescribed.
  • Previous studies suggested steroid component causes tympanic membrane perforations.
  • In vitro studies indicated ciprofloxacin's inherent toxicity to tympanic membrane fibroblasts.

Purpose of the Study:

  • To compare the in vivo effects of ciprofloxacin, dexamethasone, and their combination on tympanic membrane healing.
  • To evaluate the impact of these agents relative to ofloxacin and saline controls.

Main Methods:

  • A controlled animal study involving 54 rats with laser-induced tympanic membrane perforations.
  • Rats were randomized into six groups receiving topical ofloxacin, ciprofloxacin, dexamethasone, ofloxacin + dexamethasone, ciprofloxacin + dexamethasone, or neomycin.
  • The contralateral ear received saline as a control, with healing assessed over 40 days.

Main Results:

  • Ofloxacin did not delay healing compared to saline.
  • Ciprofloxacin, dexamethasone, and combination therapies significantly delayed healing.
  • Ciprofloxacin + dexamethasone showed the most pronounced delay, with 2 of 9 eardrums unhealed by day 40.

Conclusions:

  • Ototopical quinolones, particularly ciprofloxacin, impair tympanic membrane healing in a drug-specific manner.
  • The addition of dexamethasone potentiates the negative impact of ciprofloxacin on healing.
  • Findings suggest a need for careful consideration of ciprofloxacin and steroid use in otic preparations.
Keywords:
healingperforationquinolonesteroidtympanic membrane

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