Otitis externa

During the acute phase of the treatment, patients should be instructed on how to use ear drops to ensure adequate treatment. Patients should administer drugs into the affected ear while lying down and with the affected ear facing upwards. The patient should put in as many drops as necessary to fill the ear canal and then massage the ear canal and pinna to help the drops reach the medial end of the canal. The patient is asked to remain in that position for at least 5 minutes. Patients should avoid exposing the affected ear to water during the acute phase of the treatment.

A search for predisposing factors is helpful and sometimes necessary for effective control and prevention of recurrence. Patients should be educated to avoid the use of cotton-tipped applicators or other foreign objects. Patients who report ear pain and infections after swimming should use occlusive ear plugs. Underlying dermatitis or other skin disorders should be attended to and treated with topical corticosteroids whenever needed. A search for possible allergy to certain ear drops and/or hearing aid components should be alluded to. The need for careful blood sugar control should be stressed in patients with diabetes.