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Otitis externa - Management
What topical ear preparations are available for treatment of otitis externa?

Table 1. Topical ear preparations available in the UK for treating otitis externa.
Group
Products
Astringent/acidic preparations
Astringent and acidic
Acidic
Aluminium acetate 13% drops*
Acetic acid 2% spray (Earcalm®)
Corticosteroid preparations
Corticosteroid: lower potency
Prednisolone sodium phosphate 0.5% drops (Predsol®)
Corticosteroid: higher potency
Betamethasone sodium phosphate 0.1% drops (Betnesol®, Vista-methasone®)
Antibiotic preparations
Antibiotic: aminoglycoside
Gentamicin 0.3% drops (Genticin®)
Antibiotic: non-aminoglycoside
Chloramphenicol 5% drops
Antifungal preparations
Antifungal
Clotrimazole 1% solution (Canesten®)
Combined corticosteroid and antibiotic preparations
Aminoglycoside with corticosteroid
With neomycin
Betamethasone sodium phosphate 0.1%, neomycin sulphate 0.5% (drops: Betnesol-N®, Vista-Methasone N®)
Hydrocortisone 1%, neomycin sulphate 3400 units, polymyxin B sulphate 10,000 units/mL (drops: Otosporin®)
Prednisolone sodium phosphate 0.5%, neomycin sulphate 0.5% (drops: Predsol-N®)
Dexamethasone 0.1%, neomycin sulphate 3250 units/mL, glacial acetic acid 2% (spray: Otomize®)
Hydrocortisone acetate 1.5%, neomycin sulphate 0.5% (ointment: Neo-Cortef®)
Triamcinolone acetonide 0.1%, gramicidin 0.025%, neomycin 0.25% (as sulphate), nystatin 100,000 units/g (ointment: Tri-Adcortyl Otic®)
With gentamicin
Hydrocortisone acetate 1%, gentamicin 0.3% (drops: Gentisone HC®)
With framycetin
Dexamethasone 0.05%, framycetin sulphate 0.5%, gramicidin 0.005% (drops: Sofradex®)
Combined corticosteroid and antibiotic/antifungal preparations
Clioquinol with corticosteroid
Flumetasone pivalate 0.02%, clioquinol 1% (ear drops: Locorten–Vioform®)
* Available from manufacturers of 'special order' products.
† Available over the counter.
‡ Prescription not included as there is a 10% risk of skin sensitivity being induced.
Information from: [BNF 53, 2007]

© NHS Institute for Innovation and Improvement