I have my reservations about this composition for ear drops and how are they prepared? Bacitracin 40,000 E chloramphenicol 200mg nystatin 200,000 E triamcinolone 100mg

This composition is a compound of different formulas. I find among other things the composite ear drops with acetic acid in back, which contain per 20ml: Triamcinolone acetonide 20mg and acetic acid 0.7% in Proyleenglycol. We can therefore argue that the concentration of triamcinolone is on the high side and that triamcinolone should be replaced by T-acetonide (as in all preparations for external use). To the higher concentration of acetic acid I would not concern myself considering acetic acid will be partially neutralized by nasalicylate and-propionate.

Bacitracin I find back in ear drops 10,000 à 20,000 E per 20ml. Here The double quantity is used which is probably on the high side. You can point out the doctor and decide on him. It remains a preparation for external use and as long as there is no perforation of the eardrum there seems to be no danger to me.

the concentration of chloramphenicol is 1%. The usual is 0.5% but 1% can safely be left unchanged.

after Propionate is known to me from eye drops. I suspect that nothing prevents it from being used for disinfecting the external auditory canal. These ear drops are practically water-free; This indicates a treatment of otitis externa.

for the preparation of the water of the alcohol 60 ° can be used to dissolve the salts and bacitracin. Chloramphenicol is dissolved in propylene glycol. Triamcinolonacetonide can be dissolved in alcohol which may also dissolve nystatin in (?). After blending the alcoholic solution with the propylene glycol, we add the aqueous solution. And eventually the acetic acid.