Otitis_Externa_Management: Flashcards
What is the management for localized otitis externa?
Analgesia and local heat application using a warm flannel. Often sufficient as folliculitis tends to be mild and self-limiting.
When are oral antibiotics indicated for localized otitis externa?
Oral antibiotics are rarely indicated for localized otitis externa.
What should be done to manage acute otitis externa (<3 months)?
Keep the ears clean and dry, avoid damage to the external ear canal, and consider using over-the-counter acetic acid 2% ear drops or spray. Ibuprofen/paracetamol can be used for pain management, and antibacterial ± topical corticosteroid ear drops can be considered.
What over-the-counter treatment can be used for acute otitis externa in children over 12 years old?
Over-the-counter acetic acid 2% ear drops or spray can be used.
What can be used for pain management in acute otitis externa?
Ibuprofen/paracetamol can be used for pain management.
What antibacterial and corticosteroid ear drops can be used for acute otitis externa?
Ciprofloxacin and dexamethasone otic (0.3%/0.1%) 2x day for 7-14 days. The ear needs to be cleaned of wax first and may need a wick to deliver the drops if the ear is too swollen.
What should be done if there is treatment failure in acute otitis externa?
Consider assessing adherence and technique, arrange ear swabs for MCS, and seek specialist advice or arrange referral to an ENT specialist.
What is the management for chronic otitis externa (>3 months)?
Avoidance of triggers (e.g., swimming, scratching, aggressive cleaning), analgesia (paracetamol/ibuprofen), and consider arranging an ear swab for bacterial and fungal MCS.
What should be considered if a fungal infection is suspected in chronic otitis externa?
If a fungal infection is suspected, use clotrimazole 1% solution, acetic acid 2% spray, or clioquinol and corticosteroid (e.g., Locorten-Vioform).
How should allergic dermatitis causing chronic otitis externa be treated?
Treat allergic dermatitis with a topical corticosteroid.
How should seborrhoeic dermatitis causing chronic otitis externa be treated?
Treat seborrhoeic dermatitis with an antifungal/corticosteroid combination.
What is the recommended treatment if no cause is evident for chronic otitis externa?
Use a 7-day topical preparation containing only corticosteroid and no antibiotic, and consider co-prescribing acetic acid spray.
What should be done if malignant otitis externa is suspected?
Urgent admission is required for malignant otitis externa, with systemic antibiotics ± debridement.
summarise otitis externa management
Laz summary of otitis externa
