What is the common treatment for acute otitis externa?

• A. Oral antibiotics
• B. Topical antibiotic ear drops, with or without steroids
• C. Topical antifungal drops
• D. Oral analgesics

Answer: (B)

The main idea is that infection of the ear canal is best treated with topical therapy that delivers the antibiotic directly to the area. Topical antibiotic ear drops achieve high drug levels right at the site of infection and tend to work quickly with fewer systemic side effects. Often these drops are used with a low-dose topical steroid to reduce inflammation and edema, which helps relieve pain and improves drainage from the canal. This approach is preferred over oral antibiotics because it targets the infection locally and reduces unnecessary systemic exposure.

Oral antibiotics are generally reserved for more complicated cases—such as infection spreading beyond the canal, in patients with diabetes or immune compromise, or when topical therapy cannot be used or has failed. Topical antifungal drops are used when the cause is fungal rather than bacterial. Oral analgesics may help with pain but do not treat the underlying infection. Keeping the ear dry and avoiding irrigation or insertion of objects also supports healing.