To improve your success with all otitis cases, consider the following tips. For Pseudomonas otitis, please click here
- You can pick the most appropriate therapy by learning what organisms are present.
- Cytology is also essential for MONITORING therapy. You can compare the initial cytology to recheck cytology to learn if your therapy is helping. In some cases, the infection persists at the recheck but the organism numbers are reducing which suggests you should continue the same therapy.
- If time is a constraint, your technician can collect the swabs and read the slides.
Use large volumes of cleaner and topical medication
- The client should coat the entire canal with the ear cleaner and topical medication.
- With cleaner, the canal should be filled until it overflows with the cleaner.
- With topical medications, consider using dropper bottles to make it easy to apply 1/2 to 1mL of medication into each ear. Many commercial products conceal the applicator which makes it difficult to know if enough medication has been applied.
- Oral antibiotics or antifungals are not usually needed when large volumes of topical products are used. In fact, oral antibiotics can promote organism resistance and thus should be avoided in most otitis cases.
Use the correct frequency of therapy
- Instruct the owner to clean the canals 1-2 times per week. Cleaning too frequently can irritate the canal.
- Instruct the owner to apply medication twice a day. Infrequent medication application is a common reason for infections to persist.
Recheck the patient in two week intervals
In addition to an otoscopic exam, recheck cytology! Compare the organism counts from the first visit to the current visit. As long as the organism numbers are decreasing, continue with the current therapy. If the organism numbers are unchanged or increasing or if the organism type has changed, alter therapy.
Manage the underlying disease
To prevent otitis recurrence, look for and manage potential underlying causes of otitis including atopy, food allergy, and endocrinopathies. Less common causes include abnormal canal anatomy or neoplasia.