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.

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

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

MAIN OUTCOME MEASURES: 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.

CONCLUSION

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.