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Invasive Otitis Externa

- Most cases occur in diabetics. Extremely rare in children.

- CT or MRI scan recommended.

Usual Pathogens

P. aeruginosa

Empiric Therapy	Dose	Duration
Surgical debridement
+
Piperacillin-tazobactam	240-300mg piperacillin/kg/d IV div q6-8h	6-8 weeks (IV+PO)
+
Tobramycin	7mg/kg IV q24h

Stepdown

Empiric Therapy	Dose	Duration
Ciprofloxacin	20-30mg/kg/d PO div bid	6-8 weeks (IV+PO)