This clinical practice guideline is an update and replacement for an earlier guideline published in 2006 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. Managing any aggravating or precipitating factors such as diabetes mellitus dermatitis or ear trauma. This update provides evidence-based recommendations to manage acute otitis externa AOE defined as diffuse inflammation of the external ear canal which may also involve the pinna or tympanic membrane.
Clinical Practice Guideline Acute Otitis Externa Sciencedirect
Diffuse inflammation of the external ear canal due to bacterial or fungal infection.
Common precipitants of otitis externa are maceration trauma of the ear canal or presence of a foreign body or dermatologic diseases such as eczema psoriasis.
Pain is a common symptom of acute otitis externa and can be debilitating. 12 Oral analgesics are the preferred treatment. First-line analgesics include nonsteroidal anti-inflammatory drugs and. Acute otitis externa AOE as discussed in this guideline is defined as diffuse inflammation of the external ear canal which may also involve the pinna or tympanic membrane.
A diagnosis of diffuse AOE requires rapid onset generally within 48 hours in the past 3 weeks of symptoms and signs of ear canal inflammation as detailed in Table 1.
The multiple treatment goals with regard to AOE include pain management debris removal from the external ear canal and topical medication administration. 3 An OTC pain medication and topical eardrops are usually sufficient for most patients with AOE although in severe cases oral or intravenous antibiotics and narcotic pain medications may be required. The guideline makes eight recommendations in total. The clinical guideline for Acute Otitis Externa was created by a panel that included otolaryngologisthead and neck surgeons pediatricians infectious disease physicians family medicine professionals dermatologists and consumer advocates.
The major components of managing external otitis include.
Cleaning the ear canal treating inflammation and infection and pain control. Cleaning the ear canal Cleaning out the external canal aural toilet is the first step in treatment. Primary treatment of otitis externa OE involves management of pain removal of debris from the external auditory canal EAC administration of topical medications to control edema and infection. Otitis externa OE is diffuse inflammation of the external auditory canal with or without infection.
Also known as swimmers ear otitis externa accounts for a significant portion of ambulatory care visits during the summer months but can occur year-round in tropical or humid climates.
The updated guideline was published as a supplement in the February 2014 issue of OtolaryngologyHead and Neck Surgery. The primary purpose of the original guideline was to promote appropriate use of oral and topical antimicrobials for AOE and to highlight the need for adequate pain relief. AAO-HNSF Guidelines for Acute Otitis Externa. In 2014 the American Academy of OtolaryngologyHead and Neck Surgery Foundation AAO-HNSF released updated clinical practice guidelines for the diagnosis and treatment of acute otitis externa OE.
The recommendations included the following 3.
Otitis externa sometimes gets better without treatment but it can take several weeks. Your GP can prescribe ear drop medication that usually improves the symptoms within a few days. There are a number of different types of ear drops that may be used to treat otitis externa but they all tend to be used several times a day for about a week. Otitis externa can be caused by bacteria fungi or other germs.
Antibiotic ear drops are the treatment of choice.
3 The ear drops that your medical provider will prescribe will likely include antibiotics steroids or anti-inflammatory medication. Topical aminoglycosides are less preferred by some experts because they can cause contact dermatitis although this is rare after a short course for acute otitis externa topical acetic acid is an effective treatment and is comparable with antibioticsteroid at week one. However when treatment is extended beyond this it is less effective. Ical practice guideline on acute otitis externa and the first clinical.
Common in chronic otitis externa or after treatment of AOE with topical or 13less often systemic antibiotics.
Topical antimicrobials are beneficial for AOE but oral antibiotics 14have limited utilityNonetheless about 20 to. Antibiotic prescribing guidelines establish standards of care focus quality improvement efforts and improve patient outcomes. The table below summarizes the most recent principles of appropriate antibiotic prescribing for children obtaining care in an outpatient setting for the following six diagnoses. Acute rhinosinusitis acute otitis media bronchiolitis pharyngitis common cold and.
Management of otitis externa includes.
Assessing the severity of symptoms for example pain itch hearing loss and ear discharge.
