You are seeing a 12yo child with right ear pain for 2 days. He has been swimming recently. On examination, he has pain when you pull on the pinna of the ear to straighten the canal, and the canal is swollen and full of purulent discharge. He is afebrile and has no previous history of ear infection. Which of the following is FALSE regarding the management of this patient?
A. Systemic antibiotics play no role
B. If the patient had a history of pressure equalization tubes, neomycin + polymyxin B + hydrocortisone (cortisporin) drops would be contraindicated
C. The patient should be advised not to swim while undergoing treatment
D. Pain can be treated with antipyrine + benzocaine (auralgan) drops
E. Fluoroquinolone drops are the most commonly used antibiotic therapy
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April 27, 2017 at 9:30 am
D. The patient’s history and physical exam are most consistent with otitis externa, although perforated otitis media is in the differential. Topical antipyrine + benzocaine (auralgan) has been discontinued and is not recommended, and would also be a problem if there was a potential perforated tympanic membrane. Otitis externa should be treated only with topical, not systemic, antibiotics, and fluoroquinolones are the most commonly used antibiotics drops, and the only recommended drops is there is a potential perforation or PE tubes.