Primary care management of otitis media among Australian children

Hasantha Gunasekera, Tony E. O'Connor, Shyan Vijayasekaran, Christopher B. del Mar

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

Acute otitis media (AOM) is diagnosed on the basis of acute onset of pain and fever; a red, bulging tympanic membrane; and middle ear effusion. AOM is managed with analgesia (paracetamol or nonsteroidal anti-inflammatory drugs). Antibiotic therapy is minimally effective for most patients; it is most effective for children < 2 years with bilateral otitis media and for children with discharging ears. National guidelines recommend antibiotic therapy for Indigenous children with AOM. Evidence for corticosteroids, topical analgesia and xylitol are scant. Otitis media with effusion (OME) is diagnosed as the presence of middle ear effusion (type B tympanogram or immobile tympanic membrane on pneumatic otoscopy) without AOM criteria. Well children with OME with no speech and language delays can be observed for the first 3 months; perform audiological evaluation and refer to an ear, nose and throat (ENT) specialist if they have bilateral hearing impairment > 30 dB or persistent effusion. Children with effusions persisting longer than 3 months can benefit from a 2-4-week course of amoxycillin. Chronic suppurative otitis media is a chronic discharge through a tympanic membrane perforation. It is managed with regular ear cleaning (dry mopping or povidone-iodine [Betadine] washouts) until discharge resolves; topical ear drops (eg, ciprofloxacin); audiological evaluation; and ENT review.

Original languageEnglish
Pages (from-to)S55-S59
Number of pages5
JournalMedical Journal of Australia
Volume191
Issue numberSUPPL. 9
Publication statusPublished - 2 Nov 2009

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Povidone-Iodine
Otitis Media
Ear
Primary Health Care
Tympanic Membrane Perforation
Suppurative Otitis Media
Otitis Media with Effusion
Tympanic Membrane
Amoxicillin
Acute Pain
Ciprofloxacin
Acetaminophen
Analgesia
Anti-Inflammatory Agents
Fever
Anti-Bacterial Agents
Pharmaceutical Preparations
Therapeutics

Cite this

Gunasekera, H., O'Connor, T. E., Vijayasekaran, S., & del Mar, C. B. (2009). Primary care management of otitis media among Australian children. Medical Journal of Australia, 191(SUPPL. 9), S55-S59.
Gunasekera, Hasantha ; O'Connor, Tony E. ; Vijayasekaran, Shyan ; del Mar, Christopher B. / Primary care management of otitis media among Australian children. In: Medical Journal of Australia. 2009 ; Vol. 191, No. SUPPL. 9. pp. S55-S59.
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Gunasekera, H, O'Connor, TE, Vijayasekaran, S & del Mar, CB 2009, 'Primary care management of otitis media among Australian children' Medical Journal of Australia, vol. 191, no. SUPPL. 9, pp. S55-S59.

Primary care management of otitis media among Australian children. / Gunasekera, Hasantha; O'Connor, Tony E.; Vijayasekaran, Shyan; del Mar, Christopher B.

In: Medical Journal of Australia, Vol. 191, No. SUPPL. 9, 02.11.2009, p. S55-S59.

Research output: Contribution to journalArticleResearchpeer-review

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Gunasekera H, O'Connor TE, Vijayasekaran S, del Mar CB. Primary care management of otitis media among Australian children. Medical Journal of Australia. 2009 Nov 2;191(SUPPL. 9):S55-S59.