Further clinical guidance available from:
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
Child
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
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