Notes on otitis externa

Acute: Cyto: G+ and cocci - Neomycin
Betadine= povidone-iodine 10% - dilute 1 in 10 for 1:50 povidone iodine - intact tympanum, 1 in 20 (1:100) perforated tympanum.
culture: Staph,Strep
Chlorhexidine  2% - dilute 1:40 in water.
Acetic acid (white vinegar 5%) dilute 1:3 in water. Conc of 2 - 5% is irritating.

Cyto: G- bacilli
Culture Proteus sp, E coli
Topical: Neomycin, polymycins, gentamycin.
Acetic acid (white vinegar 5%) dilute 1:3 in water,
Povidone-iodine 1:50 intact tympanum, 1:100 perforated.

Cyto: yeast: Nystatin, thiabendazole, miconazole, clotrimazole

Chronic resistant otitis:
Yeast: topical: clotrimazole, miconazole, silvadene.
Systemic: Ketoconazole 5mg/kg twice daily for 2 to 4 weeks.
Itraconazole 5 to 10mg/kg once daily for 2 to 4 weeks.

Gram neg bacilli:
Pseudomonas sp.
Topical: Gentamycin, polymycin B, colistin or polymycin E.
Polyhydroxine iodine, diluted 1:3 to 1:5 in water and applied twice daily.
Systemic: Ormetoprim-sulfadimethoxine, trimethoprim-sulfonamide, 1st generation cephalosporin.

Pseudomonas sp. cultured.
Topical: Ticarcillen - add 4 grams to 4 oz bottle Oticlens.
Tobramycin
Enrofloxacin(Baytril) diluted 50% in water, 3 to 5 drops twice daily.
Amikacin sulfate undiluted (50mg/ml)
5 to 6 drops twice daily.
Siver sulfadiazine diluted 1:1 in water , 4 to 12 drops twice daily.
TRIS - edetic acid - gentamycin solution

Systemic
Enrofloxacin, marbofloxacin, orbofloxacin, gentamycin

Skin and skin structures:

Synulox, cephalexin, enrofloxacin.

Ears G- bacteria
Pseudomonas - painful, copious light yellow to green exudates, often ulcerated epithelium.
Proteus - light yellow exudates, ulcerated, chronicity.
E.coli - light yellow exudates
Malassezia - dog - light brown to chocolate brown exudate; cat brown.

G+ bacteria
Staph - light brown, pale yellow
Strep (Beta hemolytic) light yellow to light brown.

Otodectes cynotis (ear mite) - dark brown exudates.

Antifungal in ears:
Chlorhexidine
Thiabendazole
Silver sulfadiazine
Clotrimazole
Nystatin
Monosulfiram
Miconazole
Zinc undecylenate