BNF for Children 2011-2012

536 12.1.1 Otitis externa BNFC 2011–201212 Ear, nose, and oropharynxSofradex c (Sanofi-Aventis) AUDrops (for ear or eye), dexamethasone (as sodiummetasulphobenzoate) 0.05%, framycetin sulphate0.5%, gramicidin 0.005%. Net price 10 mL = £6.25Excipients include polysorbate 80Doseear, instil 2–3 drops 3–4 times daily; eye, section 11.4.1FLUMETASONE PIVALATE(Flumethasone Pivalate)Cautions see notes aboveContra-indications see notes aboveSide-effects see notes aboveIndication and doseEczematous inflammation in otitis externa (seenotes above); for dose, see under preparationWith antibacterialLocorten-Vioform c (Amdipharm) AEar drops, flumetasone pivalate 0.02%, clioquinol 1%.Net price 7.5 mL = £1.76Contra-indications iodine sensitivityDoseChild 2–18 years instil 2–3 drops into the ear twice dailyfor 7–10 daysNote Clioquinol stains skin and clothingHYDROCORTISONECautions see notes aboveContra-indications see notes aboveSide-effects see notes aboveLicensed use Otosporin c not licensed for use inchildren under 3 years; other preparations licensedfor use in children (age range not specified bymanufacturers)Indication and doseEczematous inflammation in otitis externa (seenotes above); for dose, see under preparationsWith antibacterialGentisone c HC (Amdipharm) AEar drops, hydrocortisone acetate 1%, gentamicin0.3% (as sulphate). Net price 10 mL = £3.92Excipients include benzalkonium chloride, disodium edetateDoseear, instil 2–4 drops 3–4 times daily and at nightOtosporin c (GSK) AUEar drops, hydrocortisone 1%, neomycin sulphate3400 units, polymyxin B sulphate 10 000 units/mL.Net price 5 mL = £2.00; 10 mL = £4.00Excipients include cetostearyl alcohol, hydroxybenzoates (parabens),polysorbate 20DoseChild 3–18 years instil 3 drops into the ear 3–4 timesdailyLicensed use licensed for use in children (age rangenot specified by manufacturers)Indication and doseEczematous inflammation in otitis externa (seenotes above); for dose, see under preparationsEye section 11.4.1Predsol c (UCB Pharma) ADrops (for ear or eye), prednisolone sodium phosphate0.5%. Net price 10 mL = £1.92Excipients include benzalkonium chloride, disodium edetateDoseear, instil 2–3 drops every 2–3 hours; reduce frequencywhen relief obtainedWith antibacterialPredsol-N c (UCB Pharma) ADrops (for ear or eye), prednisolone sodium phosphate0.5%, neomycin sulphate 0.5%. Net price 10 mL= £2.27Excipients include benzalkonium chloride, disodium edetateDoseear, instil 2–3 drops 3–4 times dailyAnti-infective preparationsCHLORAMPHENICOL UCautions avoid prolonged use (see notes above)Side-effects high incidence of sensitivity reactions tovehicleLicensed use licensed for use in children (age rangenot specified by manufacturers)Indication and doseBacterial infection in otitis externa (but see notesabove); for dose, see under preparationChloramphenicol (Non-proprietary) AUEar drops, chloramphenicol in propylene glycol, netprice 5%, 10 mL = £6.22; 10%, 10 mL = £5.62Excipients include propylene glycolDoseear, instil 2–3 drops 2–3 times dailyCLOTRIMAZOLESide-effects occasional local irritation or sensitivityLicensed use licensed for use in children (age rangenot specified by manufacturer)Indication and doseFungal infection in otitis externa (see notesabove); for dose, see under preparationPREDNISOLONE SODIUMPHOSPHATECautions see notes aboveContra-indications see notes aboveSide-effects see notes aboveCanesten c (Bayer Consumer Care)Solution, clotrimazole 1% in polyethylene glycol 400(macrogol 400). Net price 20 mL = £2.43Doseear, apply 2–3 times daily continuing for at least 14 daysafter disappearance of infection