Xtoro by Alcon Laboratories, approved December 17, 2014, is a quinolone antimicrobial indicated for the treatment of acute otitis externa caused by susceptible strains of Pseudomonas aeruginosa and Staphylococcus aureus. Prolonged use of Xtoro may lead to overgrowth of nonsusceptible organisms. Allergic reactions may occur in patients with a history of hypersensitivity to finafloxacin, other quinolones, or any of the components in this medication. Cross-resistance has been observed between finafloxacin and other fluoroquinolones but not between finafloxacin and other classes of antibacterial agents. Patients should be advised that if a rash or allergic reaction occurs, they should discontinue the use of the product immediately and contact their physician.
Before administration of Xtoro, patients or caregivers should warm the bottle by holding it in their hands for 1 or 2 minutes to avoid dizziness that may result from the instillation of a cold solution. Xtoro is administered by instilling 4 drops in the affected ear(s) twice daily for 7 days. For patients requiring use of an ear wick, the initial dose can be doubled (to 8 drops), followed by 4 drops instilled into the affected ear twice daily for 7 days.
Dosage form and strength: 5 mL of finafloxacin otic suspension, 0.3%, in an 8-mL bottle. Xtoro is a Pregnancy Category C medication. The most common adverse reactions, occurring in 1% of patients, were ear pruritus and nausea.
Source: Xtoro prescribing information.
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