What are the discharge criteria from Ear, Nose, and Throat (ENT) clinic follow-up for acute otitis externa (swimmer's ear)?

From the Guidelines

Patients with otitis externa can be discharged from ENT clinic follow-up when they demonstrate complete resolution of symptoms, including absence of ear pain, discharge, and itching, along with normal otoscopic examination showing a clean ear canal without inflammation, edema, or debris. This approach is based on the most recent and highest quality study available, which provides evidence-based recommendations for managing acute otitis externa (AOE) 1. The standard treatment regimen typically consists of topical antibiotic-steroid drops administered 3-4 times daily for 7-10 days, and discharge is appropriate when patients can recognize early symptoms of recurrence and know when to seek medical attention. Some key points to consider when discharging patients with otitis externa include:

• Ensuring the ear canal is dry and the tympanic membrane is visible and normal in appearance
• Patients demonstrating understanding of preventive measures to avoid recurrence, such as keeping ears dry during swimming and avoiding insertion of foreign objects into the ear canal
• Patients being able to recognize early symptoms of recurrence and knowing when to seek medical attention By following these guidelines, clinicians can ensure complete resolution of the infection while minimizing unnecessary follow-up visits, as most cases of otitis externa resolve completely with appropriate initial treatment 1. It is also important to note that topical antimicrobials are beneficial for AOE, but oral antibiotics have limited utility, and the use of oral antibiotics should be reserved for cases where the infection spreads beyond the ear canal or in patients with weakened immune systems 1. Overall, the key to successful management of otitis externa is prompt and effective treatment, as well as patient education on preventive measures and recognition of early symptoms of recurrence.

From the Research

Discharge Criteria from ENT Clinic Follow-up for Otitis Externa

The discharge criteria from ENT clinic follow-up for otitis externa (swimmer's ear) are not explicitly stated in the provided studies. However, the following points can be considered:

• The studies suggest that the treatment of otitis externa is usually effective, with cure rates ranging from 61.2% to 97% 2, 3, 4, 5, 6.
• The resolution of symptoms such as ear pain, discharge, and inflammation can be used as indicators of treatment success 3, 6.
• The studies also suggest that the use of topical antibiotics, antiseptics, and steroids can be effective in treating otitis externa, with no significant differences in cure rates between these treatments 3, 4, 5, 6.
• The time to end of ear pain can be used as a secondary outcome measure to evaluate the effectiveness of treatment 6.

Key Points to Consider

• The provided studies do not explicitly state the discharge criteria from ENT clinic follow-up for otitis externa.
• The resolution of symptoms and the effectiveness of treatment can be used as indicators of discharge readiness.
• Further research is needed to establish clear discharge criteria for otitis externa.
• The studies suggest that a combination of clinical and microbiological outcomes can be used to evaluate the effectiveness of treatment 3, 4, 5, 6.