Acute Otitis Externa (also known as “swimmer’s ear”) is a diffuse inflammation of the external ear canal, which may also involve the auricle or the tympanic membrane.

It is a rapid onset condition which symptoms include:


(often severe)
itching, or
fulness, with or without
hearing loss
and jaw pain,
and signs of ear canal inflammation

Nearly all cases of Acute Otitis Externa are bacterial

The most common pathogens are Pseudomonas aeruginosa (20%-60% prevalence) and Staphylococcus aureus (10%-70% prevalence), often occurring as a polymicrobial infection.

What causes “swimmer’s ear”?

  • The most common cause of infection is excess moisture trapped in the external ear canal of showers, swimming, baths in the pool or hot springs and wet climates.
  • Other causes predisposing is excessive duct cleaning with inappropriate elements that generate local trauma and injuries due to scratching. Also changes in skin pH by washing with soapy water or using alkaline drops.

How frequent is “swimmer’s ear”?

  • It is estimated that 2.4 million U.S. health care visits result in a diagnosis of Acute Otitis Externa annually (8.1 visits/1,000 population), affecting at least 1 in 123 persons each year.
  • In 2007, 1 in 324 emergency department visits and 1 in 481 ambulatory care clinic visits resulted in a diagnosis of Acute Otitis Externa.

Which impact does it have on health care services?

  • Non-hospitalized visits for Acute Otitis Externa cost more than $489 million in direct health care costs in the US. Also, in 2004, an estimated $310 million was spent on ototopical medicines.
  • A median of 15 minutes is spent per patient diagnosing and treating Acute Otitis Externa in the outpatient setting. US ambulatory health care providers expend an estimated 598,000 hours on patients with Acute Otitis Externa annually.

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