When it comes to clearing aural discharge, topical quinolone antibiotics are better than systemic antibiotics.

This finding was disclosed by a systematic review of literature published in an update of The Cochrane Library.

The complication, generally, happens in the first five years of life and can persist to adulthood. Untreated chronic suppurative otits media (CSOM) may result in permanent loss of hearing because of damage of small sound-transmitting bones in the middle ear.

From News-Medical.Net:

A systematic review of literature found that short courses of topically administered quinolone antibiotic drops such as ciprofloxacin were more effective at drying the ear than oral or injected antibiotics. The Review Authors were unable to find enough high quality data to assess the value of topical non-quinolone antibiotics that do not contain steroids, or of antiseptic treatments, when compared to systemic treatments.

“Less is known about the longer-term outcomes, or about treating complicated CSOM,” says lead author Carolyn Macfadyen a Research Associate at the International Health Research Group in the Liverpool School of Tropical Medicine, UK.

The Review Authors also noted that the evidence regarding safety of topical antibiotics is weak, and believe that clinicians should watch for any signs of ototoxicity when using topical treatment, particularly for non-quionlones such as aminoglycoside.

It was remarked by Macfadyen that the cost effectiveness of alternative treatments would prove important to guide both clinical practice and health policy.