Primary Care Liaison

Otitis externa

  • This pre-referral guideline covers Otitis externa in children of all ages.

    Initial work-up

    • History – usually due to water contamination following swimming or children with dermatitis of the external ear canal.
    • Presents with inflammation of the ear canal and pre-auricular tenderness.
    • Swab ear discharge for microscopy/culture and sensitivity. 

    Pre-referral treatment

    • Ear toilet.
    • Topical antibiotics (i.e. soframycin).
    • An ear wick should be inserted when the ear canal is very oedematous (to maintain patency of the ear canal and allow topical antibiotics to enter the ear canal) and moistened frequently with topical antibiotics.

    When to refer

    • Ear pain is severe and not relieved by regular analgesics.
    • Cellulitis has extended beyond the ear canal. Child will need IV antibiotics.
    • Bring pathology results if done.

    Referral form (pdf)

    Parent handout (pdf)


    Kids Connect (RCH Primary Care Liaison)

    Kids Health Info (Parent fact sheets online)

    Contact information

    Clinical advice

    Switchboard – ask for ENT specialist consultant or registrar on-call    (03) 9345 5522
    RCH Emergency Department (03) 9345 6477


    Booking enquiries and appointment rescheduling (parents) (03) 9345 6180 
    Rural doctors only (03) 9345 6789 

    Admission enquiries

    General admission enquiries  (03) 9345 6172

    ED admission enquiries 

    (03) 9345 6477
    After hours/switchboard

    (03) 9345 5522


    Seriously unwell child (03) 9345 7007

    RCH Drug info-line 

    (03) 9345 5208


    Paediatric Handbook Ear, Nose and Throat Conditions, Chapter 21 (pp312-324); Robert Berkowitz and Michael Marks; Seventh Edition, Blackwell Publishing. By the staff of the Royal Children's Hospital, Melbourne, Australia

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