Medical therapy of otitis externa and otitis media

Medical regimens for the successful treatment of infectious otitis may vary widely depending on the degree of pathologic changes of the external ear canals, the status of the tympanic membranes, and the specific microorganisms involved. Chronic otitis media is especially problematic, because impaction of the bullae can be difficult to resolve and these cases often involve antibiotic-resistant bacterial organisms. In fact, the continuing emergence of resistant Pseudomonas spp and Staphylococcus spp will ensure that the medical therapy of otitis remains a dynamic art for the foreseeable future. This article considers the specific antimicrobial agents available for otic use, their potential toxicities, and guidelines for their use.