Otitis Externa Empiric Therapy 

Updated: Dec 24, 2018
Author: Samuel Lee, MD, MS, FACEP; Chief Editor: Michael Stuart Bronze, MD 

Empiric Therapy Regimens

Empiric therapeutic regimens for otitis externa are outlined below, including those for chronic otitis externa, uncomplicated bacterial infection, uncomplicated fungal infection, and malignant otitis externa.[1, 2, 3, 4, 5, 6, 7, 8]

Chronic otitis externa

See the list below:

  • Neomycin-polymyxin B–hydrocortisone otic 5 drops in the affected ear QID

Uncomplicated bacterial infection

See the list below:

  • Acetic Acid 2% with or without hydrocortisone otic 4 drops in the affected ear QID for 7d or 

  • Ciprofloxacin-hydrocortisone otic 3 drops in the affected ear BID for 7d or

  • Neomycin-polymyxin B–hydrocortisone otic 4 drops in the affected ear TID or QID for 10d or

  • Ofloxacin 0.3% otic 10 drops in the affected ear once daily for 7d

Uncomplicated fungal infection

See the list below:

  • Clotrimazole 1% otic 4 drops in the affected ear QID for 7d

Malignant otitis externa

See the list below:

  • Ciprofloxacin 400 mg IV q12h for 14d or

  • Cefepime 2 g IV q12h or

  • Piperacillin-tazobactam 3.375 mg IV q8h