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Clinical Practice Guideline: Acute Otitis Externa

Clinical Practice Guideline: Acute Otitis Externa


The updated guideline was published as a supplement in the February 2014 issue of Otolaryngology——Head and Neck Surgery.

The primary purpose of the original guideline was to promote appropriate use of oral and topical antimicrobials for AOE and to highlight the need for adequate pain relief. An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. The target patient is aged 2 years or older with diffuse AOE. Differential diagnosis will be discussed, but recommendations for management will be limited to diffuse AOE, which is almost exclusively a bacterial infection.  This guideline is intended for primary care and specialist clinicians, including otolaryngologists – head and neck surgeons, pediatricians, family physicians, emergency physicians, internists, nurse–practitioners, and physician assistants. This guideline is applicable in any setting in which patients with diffuse AOE would be identified, monitored, or managed.

Leadership: Richard M. Rosenfeld MD, MPH (Chair), Seth Schwartz, MD, MPH (Methodologist) 

Guideline Update Group: C. Ron Cannon MD, Peter S. Roland MD, Geoffrey R. Simon MD, K. Ashok Kumar, MD, FRCS, FAAFP, William W. Wang, MD, MPH, Helen W. Haskell, MA


American Academy of Family Physicians, September, 2014

Society of Otorhinolaryngology-Head and Neck Nurses, Inc . Oct 2011 (original 2006 Guideline)


For Physicians
For Patients

In 2012 the ABIM Foundation launched Choosing Wisely® with a goal of advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.

Choosing Wisely centers around conversations between providers and patients informed by the evidence-based recommendations.

Access the AAO-HNSF Choosing Wisely List of 10 Things Providers and Patients Should Question

Oral antibiotics have significant adverse effects and do not provide adequate coverage of the bacteria that cause most episodes; in contrast, topically administered products do provide coverage for these organisms. Avoidance of oral antibiotics can reduce the spread of antibiotic resistance and the risk of opportunistic infections.

For Media & Public