Otitis Externa
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Features
- Painful erythema and edema of the ear canal skin.
- Diffuse inflammation of ear canal with crusts and discharge from ear.
- In diabetic or immunocompromised patients, osteomyelitis of the skull base ('malignant external otitis') may occur.
Management
- Protect the ear from additional moisture and avoid further mechanical injury by scratching.
- Clean ear with cotton wick.
- Dexatob 1 Dexcip ear drops 2 drops x TDS 'OR' Local dressing with Ichthhamolglycerine if there is swelling for 24-48 hours.
- when cellulitis of the periauricular tissue has developed—Tab- Novidat l Cipval (ciprofloxacin) 500mg PO x BD for 1 week (fluoroquinolones are effectiveness against Pseudomonas).
- Treatment of 'malignant external otitis' requires prolonged antipseudomonal antibiotic administration, often for several months.
- Novidatl Cipval (ciprofloxacin) 200-400mg IV x BD for 1 week then Tab- Novidati Cipval (ciprofloxacin) 500-1000mg PD x BD
- To avoid relapse, antibiotic therapy should be continued, even in the asymptomatic patient, until gallium scanning indicates marked reduction or resolution of the inflammation.
- Surgical debridement of infected bone is reserved for cases of deterioration despite medical therapy.