Swimmer’s Ear: Be on the Alert For Complications

Physicians should also be aware that recurrent problems may be a sign that the person has an underlying condition, such as diabetes, said Dr. Rutka.

Need to Educate Primary Care Physicians

Although most otolaryngologists use topical agents to treat swimmer’s ear, oral antibiotics are still widely used in the primary care setting by physicians who are most often the first to see these patients. Although some feel this is overtreatment, for others it is seen as a completely ineffective treatment. The main bacteria that causes otitis externa is Gram-negative bacteria, and there are very few oral agents effective against Gram-negative bacteria, said Dr. Rutka. Unless there is a spread of infection outside of the ear canal and there is consideration of an infection with Gram-positive bacteria as well, you wouldn’t use an oral antibiotic.

Dr. Roland pointed out that getting the guidelines into the hands of primary care physicians may have the greatest impact of significantly improving care of this condition.

©2009 The Triological Society