Time for a Change? Yes, but Not to Ciprofloxacin

Abstract

quently required, leading to repeated antibiotic exposure and greater selection pressure for resistance. Hence, selecting for resistance with topical fluoroquinolone therapy for non-serious infections or for 'prophylaxis' puts the value of this class for truly serious infections under threat.To make our position clear, we are not strong supporters either of the use of topical aminoglycosides on resistance grounds. Aminoglycosides are also valuable antibiotics for serious infections. However, we know that neomycin, which is not used systemically, does not necessarily select for resistance to the standard systemic aminoglycosides such as gentamicin, and therefore not all topical aminoglycosides are alike. Unfortunately, using one fluoroquinolone topically will necessarily select for resistance to a range of valuable fluoroquinolones.The clinical problem addressed by Coates is a troublesome one, but rather than following his suggestions to lobby a wide range of groups to get ready access to ciprofloxacin ear drops, we believe that prescribers should urgently lobby the pharmaceutical industry to produce a safe and effective antimicrobial ear drop that does not have resistance implications for valuable reserve systemic antimicrobials. Australia has been very effective at controlling resistance to fluoroquinolones. We would like to keep it that way. References

Non‐ototoxic and Effective: Why We Need Ciprofloxacin Ear Drops

“…The ‘ in principle ’ comments by Turnidge and Christiansen 1 regarding antibiotic resistance and the need to reduce inappropriate usage of antibiotics are consistent with current clinical practice in Australia. On this basis their comments are not unexpected.…”