A computerized PubMed search of MEDLINE 1966-December 2005 was performed. The medical subject heading “otitis media, suppurative” was exploded and the resulting articles were cross-referenced with those mapping to the subject headings “anti-bacterial agents,” “macrolides,” “fluoroquinolones,” “clindamycin,” or “lactams,” yielding 227 publications. These articles were then reviewed to identify those that met the following inclusion criteria: 1) patient population without cholesteatoma with discharging ears through a chronic perforation, 2) intervention with topical antibiotic drops versus placebo or antiseptic drops, 3) outcome measured in terms of cessation of otorrhea. Because of the richness of the literature, randomized controlled trials (RCTs) were specifically extracted as the best evidence available. Articles in which random allocation could not be confirmed or in which other interventions were allowed were excluded. The bibliographies of the articles that met these inclusion criteria and relevant reviews were manually checked to ensure no further relevant articles could be indentified.