As we continue to learn more about ototoxicity from ototopical drugs, there are several key points we must keep in mind: Aminoglycoside antibiotics used in ototopical agents do have ototoxic potential. Reported cases of ototoxicity are relatively uncommon, but the potential for serious complications does exist. Subclinical unilateral vestibular deficits do go unrecognized. Superior alternatives to aminoglycoside drops, particularly the quinolone drops, are readily available. The quinolones are superior to the aminoglycosides in terms of safety, bacterial eradication, and clinical cure and are therefore the drops of choice for treating otorrhea in an open infected ear.