To the Editor.—

The value of ototopical antimicrobials in the treatment of otorrhea has been debated for years. Several recent articles have suggested that fluoroquinolone eardrops have the correct antimicrobial profile to treat posttympanostomy tube otorrhea and otitis externa in children. Studies showing a lack of ototoxicity and efficacy similar to oral amoxicillin-clavulanate led the Food and Drug Administration to approve ofloxacin for treatment of otitis externa and tube otorrhea in children. Several authors have advocated the use of fluoroquinolone drops as first-line therapy for these indications,3,4  and the pharmaceutical companies have responded with vigorous advertising campaigns for ofloxacin and ciprofloxacin drops. Little has been written about the potential complications from the widespread use of these very broad-spectrum agents.

During the summer of 2002, we noted a marked increase in the occurrence of fungal otitis externa in young children. Typically we treat 3...

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