Can fluoroquinolones be used to safely treat otitis externa (OE)?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

Fluoroquinolones are not associated with ototoxicity, and ofloxacin is safe in cases of a perforated tympanic membrane. One literature review concluded that OE can be safely treated with an otic suspension containing 0.3% ciprofloxacin and 0.1% dexamethasone and that the inclusion of dexamethasone improves treatment success rates. [19]  A German meta-analysis found a trend suggesting the superiority of quinolone monotherapy to classic combination regimens comprising a nonquinolone antibiotic plus a steroid. [23]  Finafloxacin otic suspension has been approved by the US Food and Drug Administration (FDA) for treatment of acute OE caused by P aeruginosa or S aureus.


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