Microbiological Testing of Ear Swabs

The data above shows that the number of ear swabs submitted to Pathlab for microbiological processing has steadily increased over the last few years.

The external auditory canal is not a sterile site, and the value of microbiological culture in the routine management of Otitis Externa and Chronic Suppurative Otitis Media is limited.

Ear swabs should only be sent to the laboratory in the following situations:

• Recalcitrant otitis externa which has failed initial treatment with ear drops
• Recurrent or chronic (>2 weeks) otitis externa
• Topical treatment cannot be delivered effectively
• There is evidence the infection has extended beyond the external auditory canal (e.g. osteomyelitis, cellulitis, nerve palsy)
• The condition is complex/severe enough to warrant systemic antimicrobial treatment
• Presence of systemic symptoms (i.e. fever) or immunosuppression
• Request by ENT specialist
• Chronic Suppurative Otitis Media (CSOM) recalcitrant to standard treatment

The inclusion of clinical details is pre-requisite, and clinical information which does not pertain to the scenarios above may result in the swab being rejected.

To practice effective diagnostic stewardship, we would be grateful if you could adhere to the recommendations above.