INTRODUCTION
Necrotising otitis externa (NOE) is a severe infection of the external
auditory canal which can progress to skull base osteomyelitis, cranial
nerve palsies, meningitis, and is frequently fatal (1). The incidence of
NOE in the UK has risen almost 600% between 2002-2017 - which may be
due to a concomitant rise in relevant risk factors such as advancing age
and diabetes mellitus (2)(3). Treatment frequently involves prolonged
treatment with parenteral antimicrobial therapy, which often
necessitates an extended hospital admission and its associated risks,
including nosocomial infection.
The extent of disease in NOE is variable and management remains
contentious. Promise has been shown in other forms of osteomyelitis for
early debridement and short course antimicrobial therapy (4). Although
the application of this paradigm to NOE offers several advantages for
patient care, the potential of de-escalation of treatment in selected
cases of NOE remains to be demonstrated.