What is the first-line treatment for otitis externa if systemic signs are present?

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The correct answer focuses on the management of otitis externa, particularly when systemic signs are present. In such cases, the first-line treatment typically involves the use of a topical antibiotic combined with a corticosteroid. The combination of dexamethasone, framycetin, and gramicidin serves this purpose effectively. Dexamethasone helps to reduce inflammation, while framycetin and gramicidin provide antibacterial coverage against the common pathogens involved in otitis externa.

When systemic signs such as fever or cellulitis are present, it's crucial to address both the bacterial infection and the inflammatory response. The topical combination provides a targeted approach, allowing for effective and localized treatment while minimizing systemic side effects.

Other options may be effective in different contexts, but they do not specifically address the dual needs for anti-inflammatory action and antibacterial coverage in a scenario with systemic signs. Therefore, the selected combination emerges as the most appropriate first-line treatment in such clinical scenarios.

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