Quinolone antibiotic eardrops are better than oral or injected antibiotics at treating middle ear infections, according to a new review of research literature. The authors noted that chronically discharging ears associated with underlying persistent eardrum perforations -- a condition called chronic suppurative otitis media (CSOM) -- are a common cause of preventable hearing impairment, according to Health Day news CSOM usually occurs during the first five years of life, but can continue into adulthood. Untreated CSOM can lead to damage of the small sound-transmitting bones in the middle ear, resulting in permanent hearing loss. When this occurs in children, they can suffer impaired language and speech development. This review of available research literature concluded that short course of quinolone antibiotic ear drops were more effective at drying the ear than oral or injected antibiotics. The review authors said there was not enough available information for them to assess the effectiveness of topical non-quinolone antibiotics that do not contain steroids, or of antiseptic treatments, compared to oral or injected antibiotics. Data regarding the safety of topical antibiotics is weak, the study authors noted. They recommended that doctors look for signs of ototoxicity when giving a patient a topical treatment, especially non-quinolones such as aminoglycoside. "The cost effectiveness of alternative treatments, preferably through economic evaluations alongside clinical trials, would be valuable in guiding both clinical practice and health policy," the authors noted.