Otitis externa is one of the most common diseases in otorhinolaryngological practice frequently requiring prescription of analgesic medications and antimicrobials. The total of 2714 patients were included in the retrospective study to evaluate bacterial etiology, effectiveness, and safety of topical empirical treatment of patients with diagnosed otitis externa during 2018—2023. The most common pathogens isolated were Pseudomonas aeruginosa (38.1%), Staphylococcus aureus (24.2%) and Staphylococcus epidermidis (12.3%). Mixed bacterial infection was observed in 17.0% of patients. Majority of patients (76.1%) complained of erythema and swelling of the ear canal area, 38.2% had otorrhea, hearing loss (35.7%), otalgia (34.7%), itching in the ear (33.3%) and peeling of the epidermis of the external auditory canal (19.2%). Out of 2545 patients included in the analysis 92.1% received a combination drug containing polymyxin B sulfate, neomycin sulfate and lidocaine hydrochloride (Anauran) as monotherapy, whereas 7.9% received it in combination with other antimicrobials. Resolution of clinical symptoms within 7 days of therapy was observed in 97.0% of patients. Eradication of pathogens was observed in 95.1% of cases. In total 99.6% of patients reported completely no side effects during the treatment course suggesting high level of effectiveness and safety of the drug.