GuidelinesEML (Adult Hospital STG)
Otitis Externa
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
ICD-10 Code: H60.2
DESCRIPTION
- Invasive infection of the external auditory canal, which can extend to involve the base of the skull with cranial nerve palsies and the temperomandibular joint.
- Presents with severe otalgia and otorrhoea, which is unresponsive to topical therapy for otitis externa.
- Most common pathogen: P. aeruginosa.
- Necrotising otitis externa typically occurs in elderly diabetics or other immunocompromised patients.
GENERAL MEASURES
- Debridement as indicated.
- Insert a dry wick such as a dried sponge, into the canal under direct vision. Remove the wick 2 days later, and replace if necessary.
MEDICINE TREATMENT
- Ciprofloxacin, oral, 750 mg 12 hourly, and refer.
REFERRAL
- For surgical debridement of necrotic bone in non-responders.
- All cases to a centre where CT scan of the affected area can be done to assess the extent of the disease.
- Cranial nerve palsies.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition