Otitis externa medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Management of otitis externa includes both cleaning the external canal and treating the infection. | Management of otitis externa includes both cleaning the external canal and treating the infection. | ||
==Antibiotic Therapy== | ==Antibiotic Therapy== | ||
Systemic antimicrobials should <u>not</u> be administered for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of the following host factors that would indicate a need for systemic therapy:<ref>{{Cite journal| doi = 10.1177/0194599813517083| issn = 1097-6817| volume = 150| issue = 1 Suppl| pages = –1-S24| last1 = Rosenfeld| first1 = Richard M.| last2 = Schwartz| first2 = Seth R.| last3 = Cannon| first3 = C. Ron| last4 = Roland| first4 = Peter S.| last5 = Simon| first5 = Geoffrey R.| last6 = Kumar| first6 = Kaparaboyna Ashok| last7 = Huang| first7 = William W.| last8 = Haskell| first8 = Helen W.| last9 = Robertson| first9 = Peter J.| title = Clinical practice guideline: acute otitis externa| journal = Otolaryngology--Head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery| date = 2014-02| pmid = 24491310}}</ref> | Systemic antimicrobials should <u>not</u> be administered for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of the following host factors that would indicate a need for systemic therapy:<ref>{{Cite journal| doi = 10.1177/0194599813517083| issn = 1097-6817| volume = 150| issue = 1 Suppl| pages = –1-S24| last1 = Rosenfeld| first1 = Richard M.| last2 = Schwartz| first2 = Seth R.| last3 = Cannon| first3 = C. Ron| last4 = Roland| first4 = Peter S.| last5 = Simon| first5 = Geoffrey R.| last6 = Kumar| first6 = Kaparaboyna Ashok| last7 = Huang| first7 = William W.| last8 = Haskell| first8 = Helen W.| last9 = Robertson| first9 = Peter J.| title = Clinical practice guideline: acute otitis externa| journal = Otolaryngology--Head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery| date = 2014-02| pmid = 24491310}}</ref> | ||
* Diabetes | * Diabetes | ||
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* Presence of tympanostomy tubes or perforated tympanic membrane (nonintact tympanic membrane) | * Presence of tympanostomy tubes or perforated tympanic membrane (nonintact tympanic membrane) | ||
===Acute Otitis Externa=== | |||
Revision as of 18:26, 14 April 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Management of otitis externa includes both cleaning the external canal and treating the infection.
Antibiotic Therapy
Systemic antimicrobials should not be administered for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of the following host factors that would indicate a need for systemic therapy:[1]
- Diabetes
- HIV infection or AIDS
- Other immunocompromised states, such as patients with malignancies receiving chemotherapy
- History of radiotherapy
- Presence of tympanostomy tubes or perforated tympanic membrane (nonintact tympanic membrane)
Acute Otitis Externa
Malignant Otitis Externa
Fungal Otitis Externa
Chronic Otitis Externa
Pain Management
Analgesic agent should be administered based on the severity of pain. Mild to moderate pain is usually managed with acetaminophen or nonsteroidal anti-inflammatory drugs given alone or in combination with an opioid. Fentanyl, morphine, and hydromorphone are indicated for procedure-related pain and moderate to severe pain.
Contraindicated medications
Viral otitis externa is considered an absolute contraindication to the use of the following medications:
References
- ↑ Rosenfeld, Richard M.; Schwartz, Seth R.; Cannon, C. Ron; Roland, Peter S.; Simon, Geoffrey R.; Kumar, Kaparaboyna Ashok; Huang, William W.; Haskell, Helen W.; Robertson, Peter J. (2014-02). "Clinical practice guideline: acute otitis externa". Otolaryngology--Head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 150 (1 Suppl): –1-S24. doi:10.1177/0194599813517083. ISSN 1097-6817. PMID 24491310. Check date values in:
|date=(help)