Otitis Externa

Dtsch Arztebl Int. 2019 Mar 29;116(13):224-234. doi: 10.3238/arztebl.2019.0224.


Background: Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.

Methods: This review is based on publications retrieved by a selective search of the pertinent literature.

Results: The treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Local antibiotic and corticosteroid preparations have been found useful, but there have been no large-scale randomized controlled trials of their use. Topical antimicrobial treatments lead to a higher cure rate than placebo, and corticosteroid preparations lessen swelling, erythema, and secretions. Oral antibiotics are indi- cated if the infection has spread beyond the ear canal or in patients with poorly controlled diabetes mellitus or immuno- suppression. Chronic otitis externa is often due to an under- lying skin disease. Malignant otitis externa, a destructive infection of the external auditory canal in which there is also osteomyelitis of the petrous bone, arises mainly in elderly diabetic or immunosuppressed patients and can be life- threatening.

Conclusion: With correct assessment of the different types of otitis externa, rapidly effective targeted treatment can be initi- ated, so that complications will be avoided and fewer cases will progress to chronic disease.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Aged
  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local*
  • Chronic Disease
  • Humans
  • Otitis Externa* / drug therapy
  • Randomized Controlled Trials as Topic


  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local