A young adult comes to the clinic complaining of significant ear pain and is diagnosed with otitis externa (OE) with an intact tympanic membrane. The NP should prescribe:

Otitis externa is an infection and inflammation of the external auditory canal, commonly caused by bacterial pathogens such as Pseudomonas aeruginosa and Staphylococcus aureus. It typically presents with ear pain, tenderness of the tragus, and sometimes discharge. Treatment is primarily topical because it delivers high local drug concentrations directly to the infected area. When the tympanic membrane is intact, combination antibiotic and anti-inflammatory ear drops are commonly used for effective symptom relief. Rationale: A. Cromolyn sodium (Opticrom) is a mast cell stabilizer used primarily for allergic conjunctivitis, not bacterial ear infections. It has no antibacterial activity and does not treat the infectious or inflammatory process seen in otitis externa. Therefore, it is not appropriate for managing this condition. B. Ciprofloxacin otic drops (Ciloxan) are effective against common bacterial causes of otitis externa, but they do not provide anti-inflammatory effects. While they may treat infection, adding a corticosteroid improves symptom relief by reducing canal inflammation, edema, and pain more rapidly. C. Ciprofloxacin/hydrocortisone otic (Cipro HC) is the most appropriate choice because it combines antibacterial coverage with anti-inflammatory effects. Ciprofloxacin treats the bacterial infection, while hydrocortisone reduces inflammation, pain, and swelling in the external auditory canal. This dual action provides faster symptom relief and improved clinical outcomes in otitis externa with an intact tympanic membrane. D. High-dose amoxicillin is not effective for otitis externa because it does not adequately cover common pathogens such as Pseudomonas aeruginosa. Additionally, systemic antibiotics are not first-line therapy for uncomplicated otitis externa when the infection is localized to the ear canal. Topical therapy is preferred due to higher local concentrations and better efficacy.