Otitis Media
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
Chronic Ear Discharge >14 Days.
- Recurrent mucoid or mucopurulent discharge onset with cold/moisture in ear.
- Non foul smelling, copious in amount.
- Tympanic membrane perforation with conductive hearing loss.
- Often amenable to surgical correction.
Management
- The medical treatment of chronic otitis media includes regular removal of infected debris, use of earplugs to protect against water exposure.
- Topical antibiotic drops (ofloxacin 0.3% or ciprofloxacin with dexamethasone) for exacerbations.
Cipotic-D/ Quniodex (topical ciprofloxacin dexamethasone) ear drops 2 drops thrice daily for 5 days
- Oral ciprofloxacin, active against Pseudomonas, 500 mg twice a day for 1-6 weeks, may help dry a chronically dischargUng ear.
- Tab- Ciproxin (ciprofloxacin) 500mg PO x BD for 1-6 weeks 'OR' Tab- Renova (Gemifloxacin) 320 mg PO x OD for 2-3 weeks.
- Tab- Brufen I Inflamatax (Ibuprofen I Flurbiprofen) 400 mg PO x SOS (for pain)
- Tab- Lorin-NSA or Softin (Loratidine) 10mg PO x OD at night for a week if there is itching or other allergic symptoms.
- If not responding: Refer to ENT surgeon.
- Definitive management is surgical in most cases. Successful reconstruction of the tympanic membrane may be achieved in about 90% of cases, often with elimination of infection and significant improvement in hearing.
- When the mastoid air cells are involved by irreversible infection, they should be exenterated at the same time through a mastoidectomy.