An audit of the management of acute otitis externa in an ENT casualty clinic

Raza, Samreen; Denholm, S. W.; Wong, Jimmy C. H.

doi:10.1017/s0022215100129469

Cited by 29 publications

(15 citation statements)

References 5 publications

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“…Lifetime incidence is up to 10%. 44 Medical costs include physician visits and prescriptions for analgesics and systemic medications, such as antibiotics, steroids, or both. Direct costs are estimated at about half a billion dollars annually, and ambulatory care providers spent about 600,000 hours treating AOE.…”

Section: Health Care Burdenmentioning

confidence: 99%

Clinical Practice Guideline: Acute Otitis Externa

Rosenfeld

Schwartz

Cannon

et al. 2014

Otolaryngol.--head neck surg.

120

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Objective. 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. 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. The variations in management of AOE and the importance of accurate diagnosis suggest a need for updating the clinical practice guideline. The primary outcome considered in this guideline is clinical resolution of AOE.Purpose. 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. An updated guideline is needed because of new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. The target patient is aged 2 years or older with diffuse AOE. Differential diagnosis will be discussed, but recommendations for management will be limited to diffuse AOE, which is almost exclusively a bacterial infection. This guideline is intended for primary care and specialist clinicians, including otolaryngologists-head and neck surgeons, pediatricians, family physicians, emergency physicians, internists, nurse practitioners, and physician assistants. This guideline is applicable in any setting in which patients with diffuse AOE would be identified, monitored, or managed.Action Statements. The development group made strong recommendations that (1) clinicians should assess patients with AOE for pain and recommend analgesic treatment based on the severity of pain and (2) clinicians should not prescribe systemic antimicrobials as initial therapy for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of specific host factors that would indicate a need for systemic therapy. The development group made recommendations that (1) clinicians should distinguish diffuse AOE from other causes of otalgia, otorrhea, and inflammation of the external ear canal; (2) clinicians should assess the patient with diffuse AOE for factors that modify management (nonintact tympanic membrane, tympanostomy tube, diabetes, immunocompromised state, prior radiotherapy); (3) clinicians should prescribe topical preparations for initial therapy of diffuse, uncomplicated AOE; (4) clinicians should enhance the delivery of topical drops by informing the patient how to administer topical drops and by performing aural toilet, placing a wick, or both, when the ear canal is obstructed; (5) clinicians should prescribe a non-ototoxic preparation when the patient has a known or suspected perforation of the tympanic membrane, including a tympanostomy tube; and (6) clinicians should reassess the patient who fails to respond to the initial therapeutic option within 48 to 72 hours to confirm the diagnosis of diffuse AOE and to exclude other causes of illness. Keyw...

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Section: Health Care Burdenmentioning

confidence: 99%

Clinical Practice Guideline: Acute Otitis Externa

Rosenfeld

Schwartz

Cannon

et al. 2014

Otolaryngol.--head neck surg.

120

View full text Add to dashboard Cite

show abstract

“…Although milder cases are often managed in primary care, severe acute otitis externa accounts for a significant proportion of workload in the emergency clinics of a typical otolaryngology department [18]. Meticulous cleaning of the external auditory canal by a traumatic micro suctioning is regarded as an important first step in the initial treatment of otitis externa.…”

Section: Discussionmentioning

confidence: 99%

Comparison of steroid antibiotic pack and 10% ichthammol glycerine pack in relieving pain of acute otitis externa in children

Adhikari

Bhatta

Bhandari

et al. 2011

International Journal of Pediatric Otorhinolaryngology

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“…While the exact incidence of otitis externa is unknown, estimates suggest 10% of people will be affected at some time throughout their lives [34]. Acute otitis externa tends to occur in warm, humid climates and in individuals with narrow ear canals [33].…”

Section: Epidemiologymentioning

confidence: 99%

Otitis Media and Externa

Irwin¹

2020

Family Medicine

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An audit of the management of acute otitis externa in an ENT casualty clinic

Cited by 29 publications

References 5 publications

Clinical Practice Guideline: Acute Otitis Externa

Clinical Practice Guideline: Acute Otitis Externa

Comparison of steroid antibiotic pack and 10% ichthammol glycerine pack in relieving pain of acute otitis externa in children

Otitis Media and Externa

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