Acute Otitis Externa (OE)
First use analgesia and aural toilet.
Cure rates similar at 7 days for topical acetic acid or topical antibiotic +/- steroid.
If cellulitis/disease extending outside ear canal, or patient systemically unwell, consider oral antibiotics (flucloxacillin or erythromycin) & refer to exclude malignant OE.
Neomycin is contra-indicated in patients with perforated tympanic membrane.
If fungal or Pseudomonal infection confirmed seek specialist advice.
First Line: acetic acid 2% ear spray
1 spray three times daily
Second Line: neomycin sulphate 0.5% + betametasone 0.1% (Betnesol-N) ear drops
3 drops three times daily
7 days min to 14 days max