Shake the drops gently to be sure the medicine is well mixed. Tilt your head back slightly and pull down on your lower eyelid. Position the dropper above your eye. Look up and away from the dropper. Squeeze out a drop and close your eye. Apply gentle pressure to the inside corner of your eye (near your nose) for about 1 minute to prevent the liquid from draining down your tear duct. If you are using more than one drop in the same eye, repeat the process with about 5 minutes between drops. If you are using drops in both eyes, repeat the process in the other eye.
Because P. aeruginosa and S. aureus are common pathogens in otorrhea, they must be considered at the time of treatment selection. Currently, no narrow-spectrum agent is available for the coverage of these two microbes. For the treatment of acute diffuse otitis externa, polymyxin B-neomycin-hydrocortisone combinations and fluoroquinolones are equally effective, and neither treatment carries known risk. The twice-daily dosing schedule of topical fluoroquinolones may improve compliance. When selecting treatment for acute otitis media with perforation, topical fluoroquinolones represent a good first-line option, although not clearly better than traditional topical therapy. For chronic suppurative otitis media topical fluoroquinolones likely represent the best choice because treatment is long, and repeated therapy is common. 18