7.5 Otitis externa
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Patient presents with painful ear and pain and tenderness on moving the pinna, itching of ear canal, ear discharge | Amoxicillin- clavulanate oral 1g BD/ IV 1.2g TDS for 5- 7 days | Local measures like ichthammol glycerine. | |
| Malignant otitis externa (Spreading infection, cranial nerve involvement, Diabetes Mellitus or immunocompromised) | Piperacillin- tazobactam 4.5g IV q6h Or Ceftazidime 2g IV q8h for 4-6 weeks | Meropenem 1g IV q8h /Imipenem- cilastatin 500mg IV q6h for 4-6 weeks | Debridement may be required. Send samples for culture at the earliest (from ear canal or surgical debridement specimen). Evaluate for osteomyelitis; Do CT or MRI, if bone is involved. |
For common etiological agents of Otitis externa, see Annexure B.7.5