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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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If you suspect malignant otitis externa arrange an urgent (same day) ear, nose, and throat (ENT) review (1,2)

  • typically a computed tomography imaging scan is typically required (2)
  • treatment includes:
    • surgical debridement
    • systemic antibiotics adequate to cover pseudomonal and staphylococcal infection, including methicillin- resistant S aureus
      • consult local guidelines
      • systemic antibiotics against Pseudomonas are required if malignant otitis externa is present, e.g. ciprofloxacin or ceftazidime, plus suitable anaerobic cover e.g. metronidazole
    • biopsy may be necessary to detect neoplasia if the diagnosis of malignant otitis externa is uncertain or response to therapy is incomplete

Reference:

  • Barry V et al. 10-Minute Consultation - Otitis externa. BMJ2021;372:n714http://dx.doi.org/10.1136/bmj.n714
  • Rosenfeld RM, Schwartz SR, Cannon CR, etal. Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg2014;150(Suppl):S1-24.doi: 10.1177/0194599813517083 pmid: 24491310

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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