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Version Date from Date to Amendment 
1.1 November 2016 November 2018 Review Nov 16 



Southern Adelaide Local Health Network (SALHN) 

Otitis Media 
Indications for surgery are 

  Recurrent Acute Ototis Media - &gt; 4 episodes per year, or 3 episodes in 6 months 

  Persistant Otitis Media with Effusion; Unilateral effusion present for more than 6 months, Bilateral effusion 

present for more than 3 months or unilateral effusion in the only hearing ear 

  Severely retracted tympanic membrane 

Information Required  
  Number of episodes of OM and/or duration of effusion 

  If the child is of  high risk : Aboriginal or Torres Strait Islander, 

Craniofacial syndrome, Immunodeficiency, Un-immunised 

  Hearing loss and/or speech delay 

Helpful Investigations  
  Audiogram (GP s can refer children 

directly to FMC Audiology for hearing 


Fax Referrals to 
  ENT Clinic Fax:  8374 4928 


Red Flags 

 Acute mastoiditis   red fluctuant swelling over mastoid process in a child with features of AOM. Contact the on-

call ENT registrar to arrange urgent review in the Emergency Department the same day 

Suggested GP Management 
For recurrent AOM 
  Analgesia (paracetamol 15mg/kg/dose or ibuprofen 

10mg/kg/dose) and watchful waiting is appropriate 
for most children with AOM 

  In children &lt; 6 months,  high risk  children or those 
with sever bilateral disease commence oral 
amoxicillin 15mg/kg/dose, orally, TDS for 5 days 

  For non-responders switch to amoxicillin + 
clavulanate 22.5+3.2mg/kg, orally, TDS for 5-7days 

For AOM in presence of grommet 
  Clloxin 0.3% ear drops, 5 drops, twice a day for 9 days 
For OME 
  There is no strong evidence for oral antibiotics, 

antihistamines, oral steroids or auto-inflation devices 
to improve resolution of OME 

Clinical Resources 
South Australian Paediatric Practice Guidelines   Acute Otitis 
Media in Children 
Therapeutic Guidelines - Antibiotic 

Patient Information 
Parenting and Child Health. Women s and Children s Health 
Network. Available at URL: 



General Information to assist with referrals and the and Referral templates for FMC and RGH are available to 
download from the SALHN Outpatient Services website www.sahealth.sa.gov.au/SALHNoutpatients  

Approved by Prof Eng Ooi