The current pharmacologic treatment for CSOM involves combination antibiotic anti-inflammatory otic drops. Ciprodex (ciprofloxacin 0.3% / dexamethasone 0.1%) has been shown to be safe and effective in both children and adults with ear infections. Although most patients experience a relief of symptoms, clinical data from various studies show 10-15% patients do not respond to treatment (2). Recent findings suggest that the addition of N-acetylcysteine (NAC) to Ciprodex otic solution is a superior treatment for chronic otitis media compared to Ciprodex alone (3).