{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:15:24Z","timestamp":1780391724120,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,6]]},"abstract":"\n Objectives<\/jats:title>\n Off\u2010label use of Ciprodex\u00ae (ciprofloxacin\u2010dexamethasone: CPD), an antibiotic\u2010steroid combination solution, in the airway has been reported by pediatric otolaryngologists with anecdotal success. We examined national trends regarding off\u2010label CPD use including prevalence, common indications, prescriber patterns, adverse events, and accessibility.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 15\u2010item cross\u2010sectional survey was distributed to American Society of Pediatric Otolaryngology members from January\u2013April 2022. Univariate analyses were performed to compare responses for users of off\u2010label CPD versus non\u2010users. Ease of access was compared across geographies and practice types using multivariate logistic regressions.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 163 complete responses (26.6% response rate), 156 (95.7%) reported using off\u2010label CPD. Most common indications for off\u2010label CPD were tracheal granulation (87.8%,\n n<\/jats:italic>\n \u2009=\u2009137) and choanal atresia (82.1%,\n n<\/jats:italic>\n \u2009=\u2009128). Ease of access was significantly increased in the Midwest (OR:18.79, 95%CI:3.63\u20131.24,\n p<\/jats:italic>\n \u2009=\u20090.001) and West (OR:29.92, 95%CI:3.55\u2013682.00,\n p<\/jats:italic>\n \u2009=\u20090.006). Ease of access was significantly lower at tertiary referral centers (OR:0.11, 95%CI:0.01\u20130.64,\n p<\/jats:italic>\n \u2009=\u20090.041) and private practices (OR:0.04, 95%CI:0.002\u20130.33,\n p<\/jats:italic>\n \u2009=\u20090.009) compared to academic free\u2010standing children's hospitals. Two\u2010thirds of respondents reported feeling \u201cVery Comfortable\u201d with the safety profile of off\u2010label CPD; 99.4% (\n n<\/jats:italic>\n \u2009=\u2009156) felt that the benefits outweighed the risks of off\u2010label use. Seven respondents (4.5%) reported adverse events (e.g., local allergic reaction, cushingoid symptoms) from off\u2010label use.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our findings (26.6% response rate) suggest that off\u2010label CPD is commonly used by pediatric otolaryngologists, many of whom reported feeling that the benefits of off\u2010label CPD outweigh the risks. Our results establish a baseline for future efforts to assess the efficacy and safety of off\u2010label CPD and to improve its accessibility.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n \n V\n Laryngoscope<\/jats:italic>\n , 134:2922\u20132930, 2024\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.31211","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T06:59:57Z","timestamp":1703660397000},"page":"2922-2930","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessing National Trends and Perceived Safety of Off\u2010Label Ciprofloxacin\u2010Dexamethasone Use by Pediatric Otolaryngologists"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6788-0979","authenticated-orcid":false,"given":"Hemali P.","family":"Shah","sequence":"first","affiliation":[{"name":"Yale University School of Medicine New Haven Connecticut U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Medstar Georgetown University Hospital Washington DC U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2740-7516","authenticated-orcid":false,"given":"Rema","family":"Shah","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donovan","family":"Lockwood","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Yang","sequence":"additional","affiliation":[{"name":"Yale University School of Public Health New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1677-6439","authenticated-orcid":false,"given":"Tagan","family":"Rohrbaugh","sequence":"additional","affiliation":[{"name":"Yale University School of Medicine New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2010Head and Neck Surgery Cincinnati Children's Hospital Medical Center Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1522-5109","authenticated-orcid":false,"given":"Sarah E.","family":"Maurrasse","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery Yale University School of Medicine New Haven Connecticut U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-4060"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.therap.2018.02.002"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2013.844789"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/moo.0b013e3283184479"},{"key":"e_1_2_6_6_1","volume-title":"CIprodex\u2014Highlights of Prescribing 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