This protocol applies to an adult with chronic suppurative otitis media in which cholesteatoma is not suspected, and the ear has been chronically discharging — the persistently wet ear presentation.
Chronic suppurative otitis media without suspected cholesteatoma is managed differently depending on whether the ear is typically dry or wet. A chronically discharging (wet) ear in this context is likely to involve polymicrobial infection, and this distinction directly determines which treatment approach is indicated.
Given the polymicrobial nature of the chronically wet ear, initial management in this setting requires a combination of topical and oral fluoroquinolones. The complete regimen — including specific agents, sequencing, and duration — is set out in the full structured protocol.
Resolution of otorrhea by three weeks of therapy. Persistence of discharge beyond this point indicates treatment failure and requires reassessment.
Chronic suppurative otitis media without suspected cholesteatoma can be treated based on whether the ear is typically dry or wet (chronic discharge).
Chronic suppurative otitis media with a chronic discharging (wet) ear is likely to be polymicrobial (especially P. aeruginosa), therefore, initial treatment requires a combination of topical and oral fluoroquinolones.
Treatment is considered to have failed if otorrhea continues after three weeks of therapy.
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