There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Management of Malignant Otitis Externa in Patients with Diabetes Mellitus
The management of malignant otitis externa (MOE) in patients with diabetes mellitus (DM) typically involves long-term broad-spectrum antibiotics 1. The goal of treatment is to control the infection and prevent complications, such as cranial nerve paralysis.
Medical Management
- Long-term broad-spectrum antibiotics, typically antipseudomonal agents, are the mainstay of treatment 2, 3
- Treatment duration is usually 4-8 weeks 2, 3
- Control of diabetes is crucial in managing MOE 4, 5
Surgical Management
- Surgical intervention may be necessary in some cases, such as those with poor facial nerve function at presentation 1
- Procedures may include tympanomastoidectomy, external auditory canal debridement, and biopsy 1
- However, surgical intervention does not appear to improve outcomes, such as length of stay, readmission rate, or overall mortality 1
Monitoring and Follow-up
- Monitoring of therapy response is done through normalization of erythrocyte sedimentation rate, control of diabetes mellitus, and improvement of computed tomography and radioisotope scanning 4
- Regular follow-up is necessary to prevent recurrence and manage potential complications 5, 2