Specific Organisms and Therapeutic Regimens

Organism-specific therapeutic regimens for otitis externa are provided below, including those for Pseudomonas aeruginosa, Staphylococcus aureus, Candida albicans, and Aspergillus niger. Tailor antibiotic therapy based on culture sensitivities.^{[1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]}

Pseudomonas aeruginosa and Staphylococcus aureus

See the list below:

Acetic acid 2% otic with or without hydrocortisone otic 4 drops in the affected ear QID for 7 days or
Ciprofloxacin/dexamethasone otic 4 drops in the affected ear BID for 7d or
Hydrocortisone/neomycin/polymyxin B otic 4 drops in the affected ear TID/QID for 10d or
Ofloxacin 0.3% otic 10 drops in the affected ear once daily for 7d

Pseudomonas aeruginosa (malignant otitis externa)

See the list below:

Ciprofloxacin 400 mg IV q12h or 750 mg PO q12h for 4-6wk or
Cefepime 2 g IV q12h for 4-6wk or
Piperacillin/tazobactam 3.375 mg IV q6h for 4-6wk or
Imipenem/cilastatin 0.5 g IV q6h for 4-6wk or
Meropenem 1 g IV q8h for 4-6wk or
Ceftazidime 2 g IV q8h for 4-6wk

Fungi (Candida albicans, Aspergillus niger)

See the list below:

Clotrimazole 1% otic solution 4 drops in the affected ear QID for 7d (off-label use of topical solution) or
Fluconazole 200 mg PO for 1 dose, then 100 mg PO for 3-5d

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