Antimicrobial ear drops for acute diffuse otitis externa when fungal infection is suspected

For patients with acute diffuse otitis externa when fungal infection is suspected, use combination corticosteroid, antimicrobial and antifungal ear drops. Avoid ear drops containing an aminoglycoside (eg neomycin) if the patient has a tympanostomy tube in situ, or a tympanic membrane that is known or suspected to be perforated. If aminoglycoside-containing ear drops cannot be avoided, they can be used with caution because treatment is of short duration.

For treatment of acute diffuse otitis externa when fungal infection (otomycosis) is suspected, useCimolai, 2020Hajioff, 2015Kaushik, 2010Rosenfeld, 2006:

Advise patients to tilt their head to the opposite side after instilling the ear drops, and to apply gentle pressure to the tragus (by pressing on it repeatedly without causing pain) for 30 seconds.