Trade Name(s)

  • Xtoro

Ther. Class.

Pharm. Class.


Treatment of acute otitis externa (AOE) caused by susceptible strains of Pseudomonas aeruginosa or Staphylococcus aureus.


Inhibits bacterial DNA synthesis by inhibiting the DNA gyrase enzyme.

Therapeutic Effect(s):

Death of susceptible bacteria with resolution of infection.


Absorption: Minimal systemic absorption follows otic use.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE (cessation of ear pain)

oticunknown3.5 daysunknown


Contraindicated in:

  • Hypersensitivity; cross-sensitivity with other fluoroquinolones may occur.

Use Cautiously in:

  • OB:  Use in pregnancy only if potential benefit justifies potential risk to the fetus.
  • Lactation: Use cautiously if breastfeeding;
  • Pedi:  Safe and effective use in children <1 yr has not been established.

Adverse Reactions/Side Effects

GI: nausea

Local: ear pruritus

Misc: allergic reactions

* CAPITALS indicate life-threatening.
Underline indicate most frequent.



None noted.


Otic:  (Adults and Children ≥1 yr): 4 drops in infected ear(s) twice daily for seven days. Up to 8 drops may be given as an initial dose if used with an otowick.


Suspension for otic use: 0.3% suspension 5 mL in 8 mL bottle


  • Assess ear pain prior to and periodically during therapy.

Potential Diagnoses


  • Otic:  Warm suspension by holding bottle in hand for 1 to 2 min prior to dosing to avoid dizziness from instillation of cold suspension. Shake well before use. Instill 4 drops into affected ear twice daily for 7 days. May begin with 8 drops, followed by 4 drops, in patients requiring use of an otowick. Have patient lie with affected ear upward for 60 seconds to facilitate penetration of drops into ear canal. Repeat with other ear if necessary.

Patient/Family Teaching

  • Instruct patient in proper technique for instillation of drops.
  • Advise patient to notify health care professional if signs and symptoms of allergic reactions (rash) occur.
  • Advise female patients to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

Resolution of signs and symptoms of acute otitis externa (AOE).

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