[How and when is topical treatment applied into the ear?].

Topical treatment is the first-line treatment for inflammation of the external auditory canal and chronic otitis media, without the need of systemic antimicrobial drug therapy. The ear canal is cleaned mechanically, by rinsing with saline, and finally dried by suction. A bacterial or fungal culture specimen should be taken, if the inflammation does not heal with the first treatment or recurs rapidly. High local drug levels without systemic adverse effects are achieved with ear drops. A combinatorial broad-spectrum antibiotic/corticosteroid ear drop is the most effective remedy for bacterial inflammation, whereas the most important therapeutic procedure in fungal infections is cleaning and topical medication.