957 Otitis Externa (Oe) Management Review in Tayside

Abstract

Abstract Introduction Although otitis externa (OE) can usually be managed in the community, a large number are referred from GPs to ENT Emergency Clinics. Aim To assess primary care referrals of OE to NHS Tayside, with adherence to local guideline recommendations of investigations and management. Method The digital notes of patients with OE referred to NHS Tayside via Emergency Clinic between August 2021- February 2022 were examined, focusing on their swab sampling status, microbiology lab results and antibiotic treatment modalities. The resultant data was analysed and compared to data from the initial (Jan 2016 - Jul 2016) OE Audit. Results 53 of the 518-patient seen in ENT Emergency clinics were referred with OE. 96.2% of these patients had swabs performed for culture and sensitivity (C&S) analysis. 18.9% had been treated with oral antibiotics despite no recorded signs of external infection. Pseudomonas (17.6%) and Candida (19.6%) were the most common organisms. Conclusions Comparisons to the initial audit shows that there has been a marked improvement in patients being swabbed prior to referral (96.2% compared to < 65%). The percentage of patients with candidal growth were higher this time. However, it is possible that the previous insufficient swabbing may have led to incorrect treatment. Fewer patients were needlessly prescribed oral antibiotics when compared to the initial audit results. Oral antibiotics should only be prescribed if facial involvement is present. Swabbing and C&S aids effective treatment with an appropriate antibiotic choice.