August 16, 2019
Ear Canal Infections (Acute Otitis Externa)
Acute otitis media (AOM) is a very common type of ear infection which usually occurs in
children but can occur in adults.
Often the cause is a viral infection i.e.“ a cold” which results in inflammation behind the
ear drum with consequent severe ear ache, deafness, buzzing in the ear and a
The ear drum appears red and bulging.
Usually the AOM resolves spontaneously after 3 days without antibiotics and
paracetamol or ibuprofen should be used to relieve pain and a high temperature.
A perforation of the ear drum may occur and is suggested by increasing ear pain which
suddenly gets better with the appearance of pus and blood coming out of the affected
ear. The patient usually gets rapidly better and the perforation heals spontaneously.
Antibiotics may be given in specific situations such as: –
a) If the patient has a high temperature and is very unwell
b) Is suffering from chronic diseases such as heart disease, poor immunity or
c) A child with foul ear discharge
d) A child under 2 with foul ear discharge from both ears
e) Appears to be developing serious complications.
At present the evidence to support the use of antibiotic ear drops in AOM with an ear
discharge i.e. suspected perforated ear drum, is unproven and there is a risk of injury to
the inner ear if the ear drop contains an aminoglycoside based antibiotic.
A very small number of patients develop severe complications such as weakness of the
face muscles, mastoiditis (where the bone behind the ear becomes very red and
tender), meningitis and brain abscesses. All of these complications require urgent
diagnosis and treatment.