Which statement about Otitis Externa treatment is correct?

• A. Aminoglycoside otic preparations are preferred regardless of tympanic membrane status.
• B. Oral antibiotics alone are sufficient.
• C. Topical antifungal drops are the first-line therapy.
• D. Ciprofloxacin/dexamethasone is used; Ofloxacin is safe if tympanic membrane perforation is present.

Answer: (D)

Otitis externa is treated best with topical therapy that delivers high concentrations of antibiotic to the ear canal, targeting the typical culprits like Pseudomonas and Staphylococcus. A crucial detail is the tympanic membrane status: if the membrane is ruptured, avoid aminoglycoside otic drops because of the risk of ototoxicity, so we favor fluoroquinolones. Using ciprofloxacin/dexamethasone combines antibiotic action with anti-inflammatory effect, a common first-line choice for this condition. Ofloxacin, another fluoroquinolone, is safe to use even when the tympanic membrane is perforated, making it appropriate in those cases. Topical antifungal drops aren’t first-line unless a fungal infection is suspected, and oral antibiotics alone don’t adequately treat the localized infection of the ear canal.