ENT 1.1 Otitis externa - unknown pathogen

Content version: U-55.2
Updated: 10/20/2025 - 14:04

Recommendations

≥ 18 years
	Dosage	Remarks
	flucloxacillin oral 500 mg 4 times daily 7 days + ciprofloxacin oral 750 mg 2 times daily 7 days	In case of signs of systemic infection take a culture and supplement local treatment with

≥ 18 years

Indications: Allergy to penicillins*
	Dosage	Remarks
	clindamycin oral 600 mg 3 times daily 7 days + ciprofloxacin oral 750 mg 2 times daily 7 days

Comments

*See protocol Policy for allergy to antibiotics | Radboud UMC

Local treatment

Acidic ear drops containing hydrocortisone 1% otic preparation or acidic ear drops containing triamcinolone acetonide 0.1% otic preparation, 3 times daily, 3 drops for 1–2 weeks
If the ear canal is swollen, apply drops to a wick
Remove debris before starting local therapy
If there is no response after primary treatment of uncomplicated otitis externa, ENT specialist consultation is indicated

In case of tympanic membrane perforation

Aluminium acetate–tartrate ear drops 1.2% otic preparation, 3 times daily, 3 drops for 1–2 weeks
Do not use a wick when the ear canal is open