Project status

December 2023: Target of 350 patients being recruited has been achieved.


This study seeks to describe the demographics, clinical characteristics, surgical and medical management of prospectively identified cases of Necrotising Otitis Externa (NOE) presenting to UK NHS sites.


NOE incidence is increasing in the UK. The disease is associated with considerable mortality; one case series reported overall survival of 38% at 5 years with disease specific mortality of 14%.

No established national or international diagnostic or treatment guidelines exist to inform the management. Published data on NOE is extremely limited and predominantly consists of small, retrospective case series and descriptions of anecdotal experience.

The optimal strategy for the diagnosis and management of NOE therefore remains uncertain and a recent publication has suggested wide variability in approach across the UK. There are also concerns regarding the management of NOE from an antimicrobial stewardship perspective, as patients typically receive prolonged courses of empirical, broad-spectrum antimicrobials on the basis of an extremely limited evidence-base.

Before high-quality, clinical trials to inform the optimal management of NOE can be planned, prospectively collected descriptive data regarding the clinical epidemiology and current management of NOE patients is required.


Any ENT or Infection doctor currently working in the UK, who would like an opportunity to be involved in a large-scale national project.


We are asking participants to prospectively collect data for new cases of NOE presenting over a 6-month period starting in early 2020.

How do I get involved?


Project lead: Dr Susanne Hodgson, Academic Clinical Lecturer, University of Oxford