May 20, 2011
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As summer approaches, CDC offers steps to avoid acute otitis externa

CDC. MMWR. 2011;60:605-609.

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Acute otitis externa leads to about 2.4 million trips to the physician, results in about 600,000 ambulatory clinic hours and costs about $500 million annually, according to a report from the CDC published online this week.

In 2007, “estimated annual rates of ambulatory care visits for [acute otitis externa] during 2003-2007 were highest among children aged 5-9 years (18.6) and 10-14 years (15.8); however, 53% of visits occurred among adults aged >20 years (5.3),” the CDC researchers wrote, adding that incidence peaked during summer months.

Pseudomonas aeruginosa and Staphylococcus species were responsible for a number of acute otitis externa (AOE) infections, and the bulk of these bugs can be found in pools and at other recreational water venues, the researchers said, adding that it is important to differentiate AOE from other painful ear conditions, such as acute otitis media, because in the case of AOE, systemic antimicrobials are not indicated unless complicated by an associated cellulitis. Most AOE cases can be treated with topical ear drops.

“Most people think of swimmer’s ear as a mild condition that quickly goes away, but this common infection is responsible for millions of illnesses and substantial medical costs each year,” Michael Beach, PhD, CDC’s associate director for healthy water, said in a statement about the study. “By taking simple steps before and after swimming or coming in contact with water, people can greatly reduce their risk of this painful infection.”

Beach and colleagues recommend:

  • When around water, keep ears as dry as possible.
  • Dry ears after swimming or showering.
  • Refrain from putting objects in the ear canal or removing ear wax yourself because both can damage the skin in the ear, potentially increasing the risk for infection.
  • Talk to clinicians about using alcohol-based ear drops after swimming.

The CDC said people should consult with their health care provider if their ears are itchy, flaky, swollen or painful, or have fluid draining from them.

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