title: Audit of otitis externa referrals and management in a tertiary care setting.
abstract: OBJECTIVE
  To assess the initial management of acute otitis externa (AOE) in primary care and the appropriateness of referrals to the otolaryngology department.
  
  
  METHODS
  Prospective audit.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Data were collected from 100 consecutive patients referred by their general practitioners (GPs) during a 6-week period to our otolaryngology department. A working diagnosis of AOE was made either by the GP or in the otolaryngology urgent referral clinic.
  
  
  METHODS
  The referring diagnosis, time lag before referral, investigations prior to initial management, and any patient advice given.
  
  
  RESULTS
  Of 100 patients referred, 98% had AOE, 60% were referred with a correct diagnosis, and 30% referred had no diagnosis. Of all the referrals, nearly half were prescribed oral antibiotics, with 11% being treated with oral antibiotics exclusively; 59% had topical antimicrobials prescribed; and 24% were given no treatment. Seventy-three percent of patients were referred within 2 weeks following initial presentation to primary care, and the majority received no advice regarding their condition and/or precautions.
  
  
  CONCLUSIONS
  AOE is one of the most common adult otologic conditions presenting to the GP. Based on our results, most patients presenting with this common problem are not receiving optimal initial management or advice prior to otolaryngology referral. Greater awareness of the correct management of AOE in the community is needed. An overview of AOE and its management is provided.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Royal National Throat, Nose and Ear Hospital, London, UK. aarontrinidade@gmail.com
authors.forename: Aaron
authors.initials: A
authors.lastname: Trinidade
authors.forename: Asad
authors.initials: A
authors.lastname: Qayyum
authors.forename: Angharad
authors.initials: A
authors.lastname: Lee
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shakeel
authors.forename: Sophie
authors.initials: S
authors.lastname: Osbourne
authors.forename: Bhik
authors.initials: B
authors.lastname: Kotecha
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D054869:Clinical Audit / Q000379:methods*; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010032:Otitis Externa / Q000175:diagnosis* / Q000188:drug therapy; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D012017:Referral and Consultation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents