Will ofloxacin ear drops affect children's growth?

Without further ado, let me first state the conclusion:

On December 19, 2017, the Guangdong Pharmaceutical Association issued the "Expert Consensus on the Use of Fluoroquinolone Antimicrobial Drugs in Children", which pointed out that systemic (oral/intravenous) fluoroquinolone antibiotics can cause cartilage and joint damage in animals, but so far, there is no evidence that topical use of fluoroquinolones (eye drops/ear drops) will have any adverse effects on joints. Topical use of fluoroquinolones is mainly used to treat conjunctivitis, corneal ulcers, and otitis media/externa.

Fluoroquinolone antibiotics mainly inhibit bacterial DNA gyrase and topoisomerase IV, hindering the replication of bacterial DNA and thus exerting their antibacterial effects. Ofloxacin is a type of fluoroquinolone antibiotic.

Fluoroquinolones may cause joint and cartilage damage, so their use in children is limited. The instructions for use of most fluoroquinolone antibacterial drugs in China stipulate that they should not be used, should be avoided, or are contraindicated in children under 18 years old, pregnant women, or breastfeeding women.

Parents should not panic. For local, short-term use ofloxacin ear drops, it will not affect the child's bone development or growth. Parents can use it with confidence according to the doctor's instructions.

How to use ofloxacin ear drops: 6 to 10 drops for adults, 2 to 3 times a day. After ear drops, perform an ear bath for about 10 minutes. Increase or decrease the number of ear drops according to symptoms, and reduce the number of drops for children. Ear bath requirements: The child lies on his side with the external auditory canal opening facing upwards, and the ear drops are dripped into the external auditory canal, filling the external auditory canal as much as possible. Let it stand for 10 minutes, then change the position to allow the liquid to flow out.

References: 1. Guangdong Pharmaceutical Association "Expert consensus on the use of fluoroquinolone antibiotics in children". 2. Xu Yaxiong, Li Chuling, Yang Gang, Wang Yuanming. Analysis of the clinical efficacy of ofloxacin ear drops for acute suppurative otitis media in children[J]. Chinese Journal of Modern Drug Application. 2019(6):135-136.
(Sun Chong, Henan Provincial Children's Hospital)