Rational approach to the treatment of otitis externa

In recent years, there has been an increased number of calls to ENT specialists concerning otitis externa. These conditions are characterized by antibiotic resistance of key pathogens, as well as the presence of significant pain symptoms. In 60–98% of cases, inflammation in the external auditory canal has a bacterial etiology. Pseudomonas aeruginosa occupies a leading place in the microbial landscape — up to 78% on average, while Staphylococcus aureus is sown only in 9–27% of cases. Rational therapy of otitis externa is one of the urgent problems of otorhinolaryngology, despite the large variety of treatment methods. It is necessary to use complex therapy of external otitis, including a direct effect on the etiological factor, as well as pain relief. In the vast majority of cases, the frontline empirical therapy of otitis externa should be topical antimicrobial agents. The following combined drug is successfully used for the treatment of otitis externa: ear drops containing a combined antibiotic (aminoglycoside neomycin + cyclic polypeptide polymyxin B + topical anesthetic lidocaine). Early therapy of otitis externa with a combined antibiotic is the key to a fast and reliable clinical result. KEYWORDS: otitis externa, bacterial otitis, ear drops, combined antibiotic, aminoglycoside, cyclic polypeptide, topical anesthetics, neomycin, polymyxin B, lidocaine. FOR CITATION: Gurov A.V., Muzhichkova A.V. Rational approach to the treatment of otitis externa. Russian Medical Inquiry. 2022;6(7):404– 410 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-404-410.