Drug - Acetasol HC (acetic acid with hydrocortisone) otic solution - Several generic products
Therapeutic area - otitis externa
FDA approved indication
Acetic acid has antibacterial and antifungal action. Hydrocortisone reduces swelling and relieves pain and itching. This medication is used to treat certain infections of the outer ear and ear canal.
Patient has a bacterial infection of the outer ear and ear canal (otitis externa).
Patient has already tried at least two of the following for otitis externa without success
- neomycin/polymixin /hydrocortisone (Cortisporin) Otic
- ciprofloxacin or ciprofloxacin HCl/dexameth (CiproDex), or
- ofloxacin otic (Floxin Otic)
Patient has a fungal infection or mixed fungal-bacterial infection of the outer ear and ear canal that cannot be managed by acetic acid (Acetasol) without hydrocortisone.
Acetol HC is used for otitis externa. In May, the generic was removed from the market, and subsequent pricing for Acetasol HC was increased from $1.48 to about $12.90 per mL. Each bottle is 10 mL, therefore each bottle is priced at about $129.
Acute otitis externa can be safely treated with quinolone otic products (ciprofloxacin and ofloxacin), neomycin otic solutions and suspensions, such as Cortisporin (neomycin/polymixin /hydrocortisone), aminoglycoside ophthalmic solutions (gentamicin and tobramycin), and plain acetic acid solution without hydrocortisone.
Quinolone cost is in the $10 to $20 per bottle range, Cortisporin is in the $10 per bottle range, and acetic acid (no hydrocortisone) is in the $30 per bottle range.
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