Guidelines
Chronic Mastoiditis

Chronic Mastoiditis

Clinical Considerations

Mastoidectomy is indicated in cases where a mastoid abscess has formed

May present with fever, posterior ear pain and local erythema over the mastoid bone, edema of the pinna, or a posteriorly and downward displaced fracture

  • May require parenteral antibiotics, temporal bone CT, otology consultation for tympanostomy+/-mastoidectomy for severe pain, recurrent infection, ear proptosis and other complications (meningitis)
  • Is associated with recurrent otitis media or chronic otitis media
  • Antibiotics are given PO
  • Selection of the antibiotic is guided by surgical cultures and pharmacokinetic of the antibiotic (excellent oral bioavailability and excellent tissue distribution)

Microbiology

Preferred Treatment

Seek advice from ENT surgeons/Infectious disease consultant for treatment guidance

Ciprofloxacin 0.2% with Hydrocortisone 1% topical ear drops 3drops BID

If Parenteral Antibiotics Required

OR

Alternative treatment

PLUS

If MRSA colonised or at risk for MRSA infection, ADD

Duration of Treatment

The duration of treatment is based on the clinical improvement

More Information

  • Approval date: October 2021
  • Next revision date: October 2023