CSF powder is a compounded combination of:

• Chloramphenicol – broad-spectrum antibiotic

• Sulfamethoxazole (± trimethoprim) – antibacterial

• Amphotericin B (Fungizone) – antifungal

Some formulations may also include:

• Hydrocortisone (anti-inflammatory)

• Dexamethasone

• Ciprofloxacin

• Clotrimazole   

CSF powder is commonly prescribed for:

• • • • Chronic otitis externa (swimmer’s ear)

      • Chronic suppurative otitis media

      • Draining ears

      • Mastoid cavity infections

      • Post-surgical ears

      • Otomycosis (fungal ear infection)

      • Cochlear implant or perforated ears (specialist use

Ear infections often persist because moisture prevents drops from staying in contact with infected tissue.
CSF powder:

1. Absorbs moisture
2. Adheres to infected tissue
3. Delivers antibiotics + antifungal directly
4. Remains in ear longer

This dry-powder environment helps resolve infection quickly.

CSF powder is administered using a special ear insufflator (“puffer”).

Typical directions:

• 1–2 puffs into affected ear

• 1–2 times daily

• Often after ear cleaning by ENT

Once infection clears:

• • • • Maintenance: 1 puff weekly (if prescribed)

• CSF otic powder:

  • Requires prescription

  • Compounded by specialized pharmacy

  • Used under ENT supervision

  • Not commercially manufactured

  Chloramphenicol-containing otic medicines should be used only with medical guidance, especially if eardrum perforation exists.

• Powder puff sensation in ear

• Temporary fullness feeling

• Reduced drainage within days

• Improvement often in 3–7 days

Tips

• • • Keep ear dry

    • Do not insert objects

    • Follow ENT cleaning visits

    • Use exactly as prescribed

• CSF Otic Powder
  Sig: Insufflate 1–2 puffs into affected ear BID
  Disp: 1 insufflator bottle
  Refills: ___

  Available Variations

  • CSF

  • CSF-HC

  • CSF-Dexamethasone

  • CSF-Ciprofloxacin

  • CSF-Clotrimazole

  • Custom ENT formulations

  Clinical Notes

  • Ideal for chronic drainage

  • Post-mastoidectomy cavities

  • Resistant otitis externa

  • Moist canal infection