New guidelines have been issued by an expert panel from the fields of otolaryngology-head and neck surgery, pediatrics, family medicine, infectious disease, internal medicine, emergency medicine, and medical informatics on providing evidence-based recommendations for the management of acute otitis externa (AOE), more commonly known as swimmer’s ear.

One of the key recommendations by the panel is that topical preparations should be used in the initial treatment of AOE, according to an article by Newswise, and also that oral antibiotics should not be used as a treatment unless an extension outside of the ear canal or other symptoms necessitate systemic therapy. The selection of a topical antimicrobial therapy should be based on efficacy, low incidence of adverse events, likelihood of adherence to therapy, and cost, the article says.


Other key points of the recommendation include: topical antiseptics and antibiotics are the preferred therapy as they do not promote resistant bacteria; patients with a tympanostomy tube or perforated eardrum should use a quinolone antibiotic because it does not cause hearing loss; clinicians must inform patients on how to correctly apply the eardrops for them to work properly; and finally, the panel does not recommend ear candles for treating AOE because they have not been proven to be effective.