Assessing National Trends and Perceived Safety of Off-Label Ciprofloxacin-Dexamethasone Use by Pediatric Otolaryngologists.
Laryngoscope
; 134(6): 2922-2930, 2024 Jun.
Article
en En
| MEDLINE
| ID: mdl-38149706
ABSTRACT
OBJECTIVES:
Off-label use of Ciprodex® (ciprofloxacin-dexamethasone CPD), an antibiotic-steroid combination solution, in the airway has been reported by pediatric otolaryngologists with anecdotal success. We examined national trends regarding off-label CPD use including prevalence, common indications, prescriber patterns, adverse events, and accessibility.METHODS:
15-item cross-sectional survey was distributed to American Society of Pediatric Otolaryngology members from January-April 2022. Univariate analyses were performed to compare responses for users of off-label CPD versus non-users. Ease of access was compared across geographies and practice types using multivariate logistic regressions.RESULTS:
Of the 163 complete responses (26.6% response rate), 156 (95.7%) reported using off-label CPD. Most common indications for off-label CPD were tracheal granulation (87.8%, n = 137) and choanal atresia (82.1%, n = 128). Ease of access was significantly increased in the Midwest (OR18.79, 95%CI3.63-1.24, p = 0.001) and West (OR29.92, 95%CI3.55-682.00, p = 0.006). Ease of access was significantly lower at tertiary referral centers (OR0.11, 95%CI0.01-0.64, p = 0.041) and private practices (OR0.04, 95%CI0.002-0.33, p = 0.009) compared to academic free-standing children's hospitals. Two-thirds of respondents reported feeling "Very Comfortable" with the safety profile of off-label CPD; 99.4% (n = 156) felt that the benefits outweighed the risks of off-label use. Seven respondents (4.5%) reported adverse events (e.g., local allergic reaction, cushingoid symptoms) from off-label use.CONCLUSIONS:
Our findings (26.6% response rate) suggest that off-label CPD is commonly used by pediatric otolaryngologists, many of whom reported feeling that the benefits of off-label CPD outweigh the risks. Our results establish a baseline for future efforts to assess the efficacy and safety of off-label CPD and to improve its accessibility. LEVEL OF EVIDENCE V Laryngoscope, 1342922-2930, 2024.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pautas de la Práctica en Medicina
/
Dexametasona
/
Ciprofloxacina
/
Uso Fuera de lo Indicado
/
Otorrinolaringólogos
Límite:
Child
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Laryngoscope
Asunto de la revista:
OTORRINOLARINGOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos