They are safer and more effective than aminoglycosides

An estimated 1.5% of the adult population in the United Kingdom has active chronic otitis media with perforated tympanic membranes; this is comparable to the prevalence in western Europe and the United States. Although surgery is often necessary, antibiotic ear drops are frequently prescribed to control the discharge that patients may have with this condition. Until recently aminoglycoside ear drops were widely used, but concerns about ototoxicity, which occurs rarely, have restricted their use. Quinolone ear drops are an effective alternative, and there is good evidence from randomised controlled trials that they are the best choice for treating chronic middle ear infections.1 They are already in use in the United States, Canada, New Zealand, Japan, and other countries, although they are still not available in the United Kingdom because they have not been licensed by the Medicines Control Agency.

The principal organisms isolated from patients with chronic otitis media are …