H60.0/H60.5/H60.9
DESCRIPTION
Inflammation of the external ear may be one of the following:
- Diffuse: An infection of the ear canal, often due to Gram negative bacilli (especially P. aeruginosa ). Pain is increased when chewing and the lining of the canal may be either inflamed or swollen with dry or moist debris or even a white or clear discharge.
- Furuncular: Usually caused by Staphylococcus aureus . A painful localised swelling present at the entrance to the ear canal. May be precipitated by trauma caused by scratching, e.g. matchsticks, ear buds.
GENERAL MEASURES
- Exclude any underlying suppurative otitis media. If suppurative otitis media is diagnosed, see: Otitis media, chronic, suppurative.
- Most cases recover after thorough cleansing and drying of the ear.
- Keep the ear clean and dry (dry mopping).
- Do not leave pieces of cotton wool, etc. in the ear.
- Do not instil anything into the ear unless prescribed.
MEDICINE TREATMENT
Diffuse
- Does not usually require an antibiotic.
- Make a wick where possible, using ribbon gauze or other suitable absorbent cloth, e.g. paper towel to clean and dry the ear.
- Acetic acid 2% in alcohol, topical, instilled into the ear every 6 hours for 5 days.
- Instill 3–4 drops after cleaning and drying the ear.
Furuncular
Children
- Cefalexin, oral, 12–25 mg/kg/dose 6 hourly for 5 days. See paediatric dosing tool.
OR
- Flucloxacillin, oral, 12–25 mg/kg/dose 6 hourly for 5 days. See paediatric dosing tool.
Children > 7 years of age and adults
- Cefalexin, oral, 500 mg 6 hourly for 5 days.
OR
- Flucloxacillin, oral, 500 mg 6 hourly for 5 days.
Severe Penicillin allergy: (Z88.0)
Children
- Macrolide, e.g.:
- Azithromycin, oral, 10 mg/kg/dose, daily for 3 days. See paediatric dosing tool.
Children > 35 kg and adults
- Macrolide, e.g.:
- Azithromycin oral, 500 mg daily for 3 days.
REFERRAL
No response to treatment.