Otitis externa— the place for polypharmacy

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Abstract
The aetiology of otitis externa is complex and several factors are involved, either as primary initiating causes or as secondary complications. In many cases, the condition is brought about by a combination of events, resulting in dynamic changes in the physiological, anatomical and microbiological state of the ear. Thus, identification of the cause in a particular case is very often impossible, impractical, or too time-consuming. Furthermore, the expense of bacteriological investigations may not be justified because the findings can be very difficult to interpret. Therefore, there are many occasions when a combination of therapeutic agents in one preparation — polypharmacy — would be advantageous as a first-line treatment. It is important, indeed fundamental, that such a medicament should be effective against all the common aetiological factors. Ideally, an antibiotic, an antifungal, a parasiticidal and an anti-inflammatory agent should be included. The results obtained in a clinical trial with a combined preparation that met the above requirements have shown that this approach to therapy is efficacious.

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