• thorough and frequent ear canal debriclement with fine suction to allow opening of apilosebaceous unit
• aggressively manage diabetes
• evaluate for signs and symptoms of malignant external otitis (granulation tissue in the canal, cranial nerve involvement)
• Otic Drops: acidification, drying, antibiotic, or antibiotic/corticosteroid combination drops for 7—10 days (consider placing an otowick to aid drops to reach medial EAC if canal is too edematous to visualize TM)
• Oral Pain Medication: may require narcotics
• Oral Antibiotics: typically not required unless signs of cellulitis, concurrent otitis media, persistent or severe symptoms, or systemic illness
• consider culturing the EAC for recalcitrant infection
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