Otitis externa

BMJ Clin Evid. 2015 Jun 15;2015:0510.


Introduction: Otitis externa is thought to affect 10% of people at some stage, and can present in acute, chronic, or necrotising forms. Otitis externa may be associated with eczema of the ear canal, and is more common in swimmers, in humid environments, in people with narrow ear canals, in hearing-aid users, and after mechanical trauma.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of empirical treatments for otitis externa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review).

Results: Nine studies were included. We performed a GRADE evaluation of the quality of evidence for interventions.

Conclusions: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: oral antibiotics, specialist aural toilet, topical acetic acid, topical aluminium acetate, topical antibacterials, topical antifungals, topical corticosteroids, and combinations of these agents.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acetic Acid / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • Otitis Externa / drug therapy
  • Otitis Externa / therapy*
  • Therapeutic Irrigation / standards
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Glucocorticoids
  • Acetic Acid