When a perforated tympanic membrane presents with discharge raising suspicion for middle ear infection, treatment must account for the patient's allergy profile. This protocol applies specifically where an immediate (severe or non-severe) penicillin allergy or a delayed severe penicillin allergy is documented.
Tympanic membrane perforation with discharge suspicious of middle ear infection. The presence of discharge warrants microbiological assessment and targeted antibiotic therapy to address the suspected infectious component.
This patient population carries either an immediate penicillin allergy (severe or non-severe) or a delayed severe penicillin allergy. This rules out standard penicillin-based oral therapy and necessitates an alternative antibiotic selection for the systemic component of treatment.
Management combines topical antibiotic ear drops with an oral antibiotic agent chosen specifically for penicillin-allergic patients. The full structured regimen — including agent selection, dosing, frequency, and duration — is available in the complete protocol.