Utilization of Ciprofloxacin-Dexamethasone in the Airway: A Scoping Review.

Abstract

Multiple medical therapies exist to improve outcomes following surgical management of laryngotracheal stenosis. One method involves ciprofloxacin-dexamethasone (CPD) administration into the airway, although minimal information exists on this treatment. This scoping review evaluates the current literature to understand the potential utility of CPD after airway surgery. PubMed, EMBASE, Cochrane Library, Scopus, Web of Science. Databases were searched according to PRISMA guidelines. Studies were excluded if they did not administer CPD in the airway, were solely in vitro or animal studies, or lacked full text availability. From 1340 studies identified, seven met inclusion criteria, and one was added from manual searching. All eight articles were published between 2008 and 2025. Four described nebulized CPD, one discussed intratracheal drops, and three evaluated both. Four studies carefully evaluated CPD to assess efficacy and side effects across an aggregate of 167 pediatric and 53 adult patients. One group demonstrated fewer postoperative bronchoscopies and a shorter hospital stay after pediatric open airway surgery. Another study showed fewer granulation tissue events and earlier decannulation for pediatric tracheostomy patients. Side effects were infrequent, and three of the four groups reported no adverse events. In the fourth study, 4.5% of surveyed pediatric otolaryngologists observed a side effect from CPD. Although there is a paucity of literature regarding the safety and efficacy of CPD use in the airway, the available data suggest low risks and potential benefits. Further research is needed to assess safety, optimal treatment regimens, and efficacy of this off-label therapy.