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Otitis externa - what is the problem with getting it right? A mixed-methods study in primary and secondary care

Lookup NU author(s): Hassan Mohammed, Dr Michael Mather, Emerita Professor Janet WilsonORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2021 Cambridge University Press. All rights reserved. Introduction: Otitis externa (OE) accounts for 1.1-1.3% of patient presentations in primary care and 25% of urgent referrals to ENT. We aimed to explore: 1) OE clinical decision-making at the primary-secondary care interface; 2) OE prevalence; and 3) Recent trends in antimicrobial resistance in OE-related bacterial isolates and ototopical prescribing. Methods: This is a mixed-methods study drawing on data from primary and secondary care and open NHS sources. Results: 101 GP survey respondents reported frequently prescribing oral antibiotics for OE. GP consultations for OE increased 25% over 15 years. GP ototopical preparations cost the NHS £7,410,440 in 2006; £11,325,241 in 2016. 162 consecutive hospital OE-related bacterial isolates yielded 128 Pseudomonas spp., 18 resistant to gentamicin, 7 to ciprofloxacin. 10 guidelines reviewed showed systematic inconsistencies. Conclusion: GPs reported regularly prescribing oral antibiotics for OE. Antimicrobial drug resistance is common in OE. Available guidance is suboptimal.

Publication metadata

Author(s): Mohammed H, Mather MW, Lumb J, Butler CC, Wilson JA

Publication type: Article

Publication status: Published

Journal: Journal of Laryngology and Otology

Year: 2022

Volume: 136

Issue: 6

Pages: 486-491

Print publication date: 01/06/2022

Online publication date: 25/11/2021

Acceptance date: 08/06/2021

Date deposited: 06/01/2022

ISSN (print): 0022-2151

ISSN (electronic): 1748-5460

Publisher: Cambridge University Press


DOI: 10.1017/S0022215121003649

PubMed id: 34819190


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