Otitis Externa (OE)
Infection Otitis externa (OE) Brief outline/clinical setting Acute OE is defined as diffuse inflammation of the ear canal, which may also involve the pinna or tympanic membrane. Acute OE usually occurs rapidly over a 48 hour period. Patients with acute OE present with tenderness and oedema of the tragus, pinna or both, secondary to cellulitis of the ear canal skin and sub-dermis. Patients at risk
| Infection | Otitis externa (OE) |
|---|---|
| Brief outline/clinical setting | Acute OE is defined as diffuse inflammation of the ear canal, which may also involve the pinna or tympanic membrane. Acute OE usually occurs rapidly over a 48 hour period. Patients with acute OE present with tenderness and oedema of the tragus, pinna or both, secondary to cellulitis of the ear canal skin and sub-dermis. Patients at risk of OE include those with diabetes and immunocompromised patients. |
| Aetiologies/organisms | OE is usually of bacterial aetiology. Common pathogens: Pseudomonas aeruginosa Staphylococcus aureus Fungi - usually involved in chronic OE or after treatment of acute OE with antibiotics |
| Optimal antimicrobial selection |
Clinicians should prescribe topical therapy initially for diffuse uncomplicated acute OE. TOPICAL THERAPY FOR DIFFUSE UNCOMPLICATED ACUTE OE:
NON INTACT TYMPANIC MEMBRANE: Non-ototoxic topical preparation INDICATIONS FOR SYSTEMIC ANTIMICROBIALS: - Extension outside the ear canal SYSTEMIC ANTI MICROBIAL OPTIONS: In consultation with ENT and microbiology
Antimicrobials to be adjusted based on culture and susceptibility results. |
| Duration | |
| Alternative if allergic/not available | Discuss with Microbiology/ID |
| Rationale | Clinical Practice Guideline: Acute Otitis Externa Executive Summary 2014 (American Academy of Otolaryngology Head and Neck Surgery) |
| Level of evidence | High for efficacy of topical therapy |
| Link to Guideline |