👂 ENTENT / InfectiousStudentInternResident

Otitis Externa

Also known as: swimmer's ear · external ear infection

Inflammation or infection of the external ear canal — ear pain (worse on moving the tragus/pinna), itch, discharge and a red, swollen canal. Usually bacterial or fungal; watch for the dangerous necrotising ('malignant') form.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Swimmers, humid climates, ear trauma (cotton buds), and eczema/psoriasis; diabetics and the immunocompromised are at risk of necrotising otitis externa.

Red flags — escalate / refer

Severe pain out of proportion, granulation tissue in the canal, or facial-nerve palsy in a diabetic/immunocompromised patient → suspect necrotising (malignant) otitis externa — an emergency.

Work-up / diagnosis

1A clinical diagnosis (tender canal, discharge, otoscopy) — distinguish from otitis media (intact vs perforated drum).
2Swab if refractory/severe; have a high index of suspicion for necrotising OE in diabetics/immunocompromised.

Management — overview

Aural toilet/cleaning and keep the ear dry; topical treatment (antibiotic ± steroid ear drops; antifungal for fungal infection).
Analgesia; a wick if the canal is very swollen; treat the cause (stop cotton buds, manage eczema).
Necrotising otitis externa needs systemic antibiotics, imaging and specialist care.

In-depthFull dosing & advanced protocol

Drug dosing

Topical antibiotic/steroid (or antifungal) drops

Uncomplicated otitis externa

Adult dose: Per protocol; keep the ear dry
Route: Topical (aural)

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Systemic antibiotics

Only for necrotising/spreading disease

Adult dose: Per local policy (prolonged in necrotising OE)
Route: IV / oral

ICMRICMR Treatment Guidelines for Antimicrobial Use in Common Syndromes (2019) ↗

Topical first; don't miss necrotising OE

Topical treatment beats systemic for uncomplicated otitis externa.
Keep the ear dry and remove debris to help the drops work.
Necrotising OE (diabetic/immunocompromised, severe pain, granulations) needs IV antibiotics and imaging.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Otitis MediaAn acute middle-ear infection, common in children — ear pain, fever and a bulging, red tympanic membrane. Most are self-limiting; analgesia is the priority.Epistaxis (Nosebleed)Bleeding from the nose — usually anterior (Little's area) and self-limiting, occasionally posterior and serious. First aid controls most; find and treat the cause.Acute Pharyngitis & TonsillitisAcute inflammation of the pharynx/tonsils — sore throat, pain on swallowing, fever and tender neck nodes. Most cases are viral; the key is spotting group-A streptococcal ('strep') throat, which benefits from antibiotics and prevents complications.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical antibiotic/steroid (or antifungal) drops

Systemic antibiotics

📈 Topical first; don't miss necrotising OE

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Topical antibiotic/steroid (or antifungal) drops

Systemic antibiotics

📈 Topical first; don't miss necrotising OE

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Topical first; don't miss necrotising OE

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Topical first; don't miss necrotising OE

References