What are the best ways to prevent otitis externa in a child with a history of the condition?

From the Guidelines

To prevent otitis externa in a child with a history of the condition, the nurse practitioner will recommend drying the ear canal with a hair dryer, using acidifying ear drops, and avoiding trauma to the external auditory canal. The best ways to prevent otitis externa include:

• Removing obstructing cerumen
• Using acidifying ear drops shortly before swimming, after swimming, at bedtime, or all three
• Drying the ear canal with a hair dryer
• Using ear plugs while swimming
• Avoiding trauma to the external auditory canal 1. It is essential to note that using cerumenolytic agents daily is not a recommended preventive measure, and swimming only in chlorinated pools may not be sufficient to prevent otitis externa. Additionally, cleaning ear canals well after swimming is a good practice, but it is not the most effective way to prevent otitis externa. The recommended preventive measures work by maintaining the ear canal's natural protective barrier, preventing moisture accumulation that creates an environment for bacterial and fungal growth, and preserving the ear's slightly acidic pH that inhibits pathogen growth. It is crucial to follow these recommendations to reduce the risk of otitis externa in children with a history of the condition.

From the FDA Drug Label

Use dries water in the ears and relieves water-clogged ears after swimming showering bathing washing the hair The best way to prevent otitis externa in a child with a history of the condition is to dry the ear canal after swimming or bathing.

• The nurse practitioner will recommend cleaning ear canals well after swimming. 2

From the Research

Prevention of Otitis Externa

To prevent otitis externa in a child with a history of the condition, the nurse practitioner may recommend the following:

• Avoiding excessive moisture and trauma to the ear canal, as these are common precipitants of otitis externa 3
• Drying the ears with a hair dryer after exposure to moisture, as this can help prevent recurrence 3
• Avoiding manipulation of the external auditory canal, as this can also help prevent recurrence 3
• Using a topical solution of 2 percent acetic acid combined with hydrocortisone for inflammation after exposure to moisture, as this can be an excellent prophylactic measure 3
• Cleaning the ear canal thoroughly, but avoiding flushing, as this is essential for diagnosis and treatment 3

Recommendations to Avoid

The nurse practitioner may advise against:

• Using cerumenolytic agents daily, as there is no evidence to support the effectiveness of this method in preventing otitis externa 3, 4
• Swimming only in chlorinated pools, as the type of pool is not a significant factor in preventing otitis externa 3
• Relying solely on cleaning ear canals well after swimming, as while this is important, it is not enough to prevent otitis externa on its own 3, 4