First use analgesia.

Cure rates similar at 7 days for topical acetic acid or antibiotic +/- steroid.

If cellulitis or disease extends outside ear canal, start flucloxacillin and refer to exclude malignant otitis externa

Drug details

First Line:

Acetic acid 2% (EarCalm) spray

 

1 spray TDS

 

7 days

Second Line:

Neomycin sulphate with corticosteroid

 

 

3 drops TDS

 

7-14 days

If cellulitis:

Flucloxacillin 

(see Comment section above for further advice too)

 

500mg QDS

 

Child

1 month to 1 year: 62.5mg to 125mg QDS

2 to 9 years: 125mg to 250mg QDS

10 to 17 years: 250mg to 500 mg QDS

 

5 days