Which topical antibiotics should be avoided in patients with a tympanic membrane perforation? What is the antibiotic of choice?

Avoid eardrops containing gentamicin, neomycin sulfate, or tobramycin as these drugs are ototoxic when there is a tympanic membrane perforation. Ototopical fluoroquinolones are the first-line therapy of choice in this situation.


Source

Mattu, A. et al. Avoiding Common Errors in the Emergency Department.

Rosen & Barkin's 5–Minute Emergency Medicine Consult. 4th ed.