Management of acute otitis externa in India: a questionnaire based survey of ENT specialists across the country
Keywords:Otitis externa, Eardrop, Otomycosis, Neomycin, Clotrimazole, Steroid
Background: A questionnaire-based survey was conducted across ENT specialists in India to know current perception and practice of acute otitis externa (AOE) management.
Methods: The survey was conducted between January-June 2019 using a 23-item questionnaire. Questions were pertaining to epidemiology, clinical as well as microbiological features, diagnostic and management approaches. An ENT specialist who has postgraduate diploma or masters in ENT with an active practice from at least 5 years was considered eligible. 100 ENT specialists were randomly approached across India to take this survey.
Results: 68 doctors filled survey-questionnaires completely. 60 (88.23%) specialists were males, with mean age of 48.46±9.98 years. Majority agreed that AOE is polymicrobial (62,91.17%), with bacteria being either a primary pathogen or superimposed on fungal infections (otomycosis) (64,94.11%). Almost 90% respondents (61, 89.7%) agreed that empirical cover for both bacterial and fungal pathogens should be provided in AOE cases. 75% respondents (51/68) agreed that topical ear drop containing antimicrobial agents with steroid is the desirable option to manage AOE. Majority respondents (54, 79.41%) agreed that pain-relieving local anaesthetic eardrops should not be recommended in AOE as their usage can mask the symptoms. 63 respondents (92.64%) agreed that neomycin and clotrimazole have broad spectrum action and are safe in AOE.
Conclusions: Majority ENT specialists opined that AOE cases have mixed bacterial and fungal etiology, and topical eardrop containing both antibacterial and antifungal agent with steroid is the desirable empirical option to manage AOE. Local anaesthetic eardrop should not be used as it may mask the symptoms and affect patient compliance. This publication has collated viewpoints of ENT specialists in India pertaining to AOE. It can aid practitioners in getting information about the current practice in the country related to AOE.
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