Referral guideline – Otitis externa


A common infection in children usually due to:

  • water contamination, e.g. following swimming
  • trauma from cotton buds or scratching
  • dermatitis of the external ear canal.

Most cases do not require referral.

GP management

  • Address predisposing factors above.
  • Topical antibiotics as per Therapeutic Guidelines. Use Otodex or Sofradex if a bacterial cause is suspected, or Locacorten Vioform if a fungal cause is likely. Systemic antibiotics are rarely required.
  • An ear wick should be inserted when the ear canal is very oedematous.
  • Swabs may be necessary if the cause is unclear or the infection is not settling with usual topical antibiotics.
  • Keep ear dry.

When to refer

  • Occasionally recurrent episodes may require referral.
  • If cellulitis has extended beyond the ear canal or ear pain is severe and unrelieved by regular analgaesics, refer to the Emergency Department.

Essential referral info

  • Presenting complaint and reason for referral
  • Detailed history including treatment to date
  • Swab results if applicable
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/Carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Helpful referral info

  • Other past medical and surgical history
  • Antenatal and perinatal history that may be relevant – prematurity, birth weight, birth trauma, or alcohol/drug use in pregnancy
  • Family history
  • Current medications and allergies
  • Immunisations
  • Examination findings – including any dysmorphic features, full ocular examination
  • Is the patient of Aboriginal or Torres Strait Islander descent?

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111