QuestionSBA
QuestionChoice
The most likely diagnosis here is otitis externa. Mild to moderate otitis externa as in this case can be treated with topical drops including combined antibiotic/steroid drops (e.g. Gentamix), acetic acid and other preparations. It is vital that the patient is advised to keep the ear dry for the next 7-10 days too.
10005436
a
Combined topical antibiotic and steroid drops
QuestionChoice
Analgesia, ear irrigation and dry swabbing of secretions should be advised but they will not directly treat the infections per se and are therefore not as appropriate as combined topical antibiotic and steroid drops.
10005439
d
Supportive care
QuestionChoice
Chloramphenicol ear drops are rarely used in practice.
10005440
e
Topical chloramphenicol
QuestionChoice
Oral antibiotics would be considered when there is cellulitis extending beyond the external ear canal, when the ear canal is occluded by swelling and debris and a wick cannot be inserted, or in people with diabetes or compromised immunity. It is also recommended in cases of severe infection or high risk of severe infection, for example with Pseudomonas aeruginosa.
10005438
c
Oral amoxicillin
QuestionChoice
Oral antibiotics would be considered when there is cellulitis extending beyond the external ear canal, when the ear canal is occluded by swelling and debris and a wick cannot be inserted, or in people with diabetes or compromised immunity. It is also recommended in cases of severe infection or high risk of severe infection, for example with Pseudomonas aeruginosa.
10005437
b
Oral ciprofloxacin
Concept
Chapter
2693
4406
Otitis externa
Topic
186
Ear, Nose and Throat
13634
A 28-year-old woman with no significant past medical history presents with two days of right ear discomfort and discharge. Her observations are normal and she has not had a recent viral illness. On examination, the auditory canal appears erythematous and there is a small amount of debris present, but you can still see the tympanic membrane intact.

Which of the following is the most appropriate management of this patient?
a