Otitis Externa Organism-Specific Therapy

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

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]

Pseudomonas aeruginosa and Staphylococcus aureus

See the list below:

  • Acetic acid 2% 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

  • Neomycin/polymyxin B/hydrocortisone 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:

Fungi (Candida albicans, Aspergillus niger)

See the list below:

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

  • Fluconazole 200 mg PO for 1 dose, then 100 mg PO for 3-5d