In both Acute Otitis Externa and Chronic Otitis Externa, prevention is fundamental:

Avoid precipitating factors:

Minimize moisture retention, acidifying and/or alcohol drops may be placed in the ear after water exposure.

  • After water exposure, the head should be tilted and the ear gently pulled to empty any residual water.
  • Use of earplugs while swimming; use of hair dryers on the lowest settings.
  • Maintain a healthy skin barrier of the external ear canal.


The appropriate diagnosis and further treatment should be conducted by a doctor, who also should assess for factors that modify management (non-intact tympanic membrane, tympanostomy tube, diabetes, immunocompromised state, prior radiotherapy).

  • Initial therapy of diffuse uncomplicated Acute Otitis Externa is based on topical antibiotic preparations.
  • In general, systemic antimicrobials are not prescribed as initial therapy for diffuse, uncomplicated Acute Otitis Externa unless there is extension outside the ear canal or the presence of specific patient factors that would indicate a need for systemic therapy.
  • In case of pain, appropriate analgesic treatment based on the severity.

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