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Acute otitis externa in children

Colin J McWilliams1, Christine H Smith, Ran D Goldman

  • 1BC Children's Hospital, Department of Pediatrics, Room K4-226, Ambulatory Care Bldg, 4480 Oak St, Vancouver, BC V6H 3V4.

Canadian Family Physician Medecin De Famille Canadien
|November 16, 2012
PubMed

Insights

For uncomplicated acute otitis externa (AOE) in children, topical antibiotic-steroid preparations are recommended as first-line treatment. Oral antibiotics are not typically necessary for this common summer ear infection.

Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Pharmacology

Background:

  • Acute otitis externa (AOE) is frequently diagnosed in children during summer months.
  • Multiple topical ototopical preparations are available for treating AOE.
  • Current treatment guidelines for AOE vary, with a need for clarity on first-line agents.

Purpose of the Study:

  • To determine the optimal first-line treatment agent for uncomplicated acute otitis externa (AOE) in children.
  • To evaluate the role of oral antibiotics in the management of uncomplicated AOE.

Main Methods:

  • Review of current American guidelines for AOE management.
  • Analysis of a recent Cochrane review on ototopical therapies for AOE.
  • Consideration of clinical practice patterns in the absence of specific Canadian guidelines.

Main Results:

  • American guidelines advocate for initial ototopical therapy without systemic antibiotics for uncomplicated AOE.
  • Evidence suggests minimal differences among various ototopical preparations.
  • Antibiotic-steroid combination ototopical treatments demonstrate superiority over placebo or acetic acid for AOE resolution.

Conclusions:

  • Topical antibiotic-steroid formulations are recommended for 7 to 10 days for uncomplicated AOE.
  • The choice of specific ototopical agent should be guided by the clinical scenario.
  • Systemic antibiotics are generally not indicated for uncomplicated AOE.
Abstract

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