Otitis externa

Question 1

Common pathogens

Answer 1

Pseudomonas spp. and staphylococcus aureus.

Question 2

Mx

Mild/moderate - […] drops including combined […]/[…] drops (e.g. Gentamix), acetic acid and other preparations.

Keep the ear dry for the next […]-[…] days

Severe - “[…]” […] with gentamicin

Systemic/can’t use Pope wick/Pseudomonas - Oral […]

Answer 2

Mild/moderate - topical drops including combined antibiotic/steroid drops (e.g. Gentamix), acetic acid and other preparations.
keep the ear dry for the next 7-10 days

Severe - “Pope” wicks with gentamicin

Systemic/can’t use Pope wick/Pseudomonas - Oral flucloxacillin

Question 3

Complication

Answer 3

Malignant otitis externa

Question 4

When to refer to ENT

Answer 4

If a patient fails to respond to topical antibiotics then the patient should be referred to ENT

Question 5

Malignant otitis externa
- […] individuals (90% cases found in […])
- most commonly caused by […] […]
- Progresses to […][…][…]
- Mx with IV abx that cover […]

Answer 5

Malignant otitis externa
- Immunocompromised individuals (90% cases found in diabetics)
- most commonly caused by Pseudomonas aeruginosa
- Progresses to temporal bone osteomyelitis
- Mx with IV abx that cover pseudomonas