Ear

Question 1

What can be used to treat mild otitis externa first line?

Answer 1

Acetic acid 2%

• reduces pH and reduces bacterial and fungal cell growth.
• Efficacy is reduced if treatment extends beyond 1 week.

Question 2

What should be prescribed for mild to moderate uncomplicated fungal infection in a chronic otitis media context, what topical drug can be given?

Answer 2

Topical anti fungal such as clotrimazole 1% solution, acetic acid 2% spray

or

Clioquinol and a corticosteroid such as flumetasone pivalate with clioquinol

Question 3

For severe pain associated with otitis externa, what analgesics should be given?

Answer 3

Paracetamol or Ibuprofen

For more server cases:
Codeine phosphate

Question 4

What antibacterial drugs should be given to children under 3 yo with otitis media?

Answer 4

Antibacterial drugs are not usually required, especially if there is no perforation of the ear drum

Question 5

What should be considered if there is a build up of ear wax?

Answer 5

Olive or almond oil to soften wax

Sodium bicarb drops can be used but may cause dryness.