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18 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Otitis Externa |
Inflammation of the external ear canal |
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What causes otitis externa? |
Bacterial infection (Pseudomonas aeruginosa or Staphylococcus aureus) |
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What else could cause otitis externa? |
Secondary to otorhhea from otitis media |
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How to clean the ear |
Microsuction, irrigation or dry swabbing |
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What is used to treat mild otitis externa? |
Acetic acid 2% |
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How does acetic acid 2% solution work? |
Acts as an astringent in the ear canal by reducing pH and reducing bacterial and fungal cell growth |
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How long is acetic acid 2% solution most efficient? |
1 week |
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What can be used if an infection is present in otitis externa? |
A topical anti-infective with or without a corticosteroid |
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How long should topical anti-infectives be used for? |
One week, but treatment can be prolonged to a maximum of two weeks if symptoms persist |
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Why is prolonged topical anti-infective with/without corticosteroids bad? |
May affect the flora of the ear, increasing the risk of fungal infections |
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What can be used if a mild to moderate, uncomplicated infection is suspected? |
A topical antifungal e.g. clotrimazole 1% solution. Acetic acid 2% spray (unlicensed), OR clioquinol with a corticosteroid (e.g. flumetasone with clioquinol) |
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What is another astringent agent? |
Aluminium Acetate ear drops |
It's a metal that Americans mispronounce |
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What drug is contraindicated in patients with a perforated tympanic membrane (eardrum)? |
Aminoglycosides e.g. gentamicin, neomycin. Can be used if other measures have failed |
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Specialists only consider aminoglycosides eardrops for patients with perforated tympanic membranes (eardrum) in the following 4 circumstances: |
1. Only used in the presence of obvious infection 2. Treatment no longer than 2 weeks 3. Patients counselled on ototoxicity risk and given a justification for its use 4. Baseline audiometry performed before treatment commenced |
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What can be used for pain with otitis externa? |
Paracetamol and ibuprofen. Codeine for simple pain |
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Systemic (rare) antibiotics are considered when... |
Infection spreads outside ear canal, high risk group (diabetes, immunocompromised, sever infected or at risk patients) |
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When are people referred? |
Extensive swelling of the auditory canal |
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Oral antibiotic therapy |
Flucloxacillin 250-500mg QDS (aged 10- adult) ; 125-250mg QDS aged 2-9) ; 62.5-125mg QDS (aged 1 month- 1 year). Eat on empty stomach. Clarithromycin (if allergic to penicillin or erythromycin if pregnant) Ciprofloxacin 0.25ml BD for 7 days (if Pseudomonas suspected) |
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