Acute Otitis Externa (OE)

Further clinical guidance available from:

CKS - Otitis Externa guidance

First use analgesia.

Cure rates similar at 7 days for topical acetic acid or antibiotic +/- steroid. If cellulitis/disease extending outside ear canal, start oral antibiotics & refer to exclude malignant OE.

If cellulitis or disease extends outside ear canal, start flucloxacillin and refer to exclude malignant otitis externa

First Line: Acetic acid 2% (EarCalm) spray

1 spray TDS

7 days

Second Line: Neomycin sulphate with corticosteroid

(If sensitivities suggest ciprofloxacin – topical use should be used where possible – eye drops can be used in ears (unlicensed route))

3 drops TDS

7 days min to 14 days max

If cellulitis: Flucloxacillin 

(see Comment section above for further advice too)

500mg QDS



1 month to 1 year: 62.5mg to 125mg QDS

2 to 9 years: 125mg to 250mg QDS

10 to 17 years: 250mg to 500 mg QDS

7 days