Aboriginal and Torres Strait Islander health staff working with Aboriginal and Torres Strait Islander families are likely to have the greatest impact on severe otitis media.

  1. Families should be told that Aboriginal children are at greatly increased risk of severe otitis media (OM).
  2. Families should be told that severe OM will get better with improved living standards, maternal education, breast feeding, provision of a smoke free environment and pneumococcal vaccination.
  3. Families should be encouraged to attend the local health clinic as soon as possible whenever a child develops ear pain or discharge.
  4. Frequent ear examinations are recommended even when the child is well. Use pneumatic otoscopy or tympanometry whenever possible.
  5. Antibiotics (amoxycillin) are recommended for Aboriginal children with acute otitis media (identified by bulging eardrum or recent perforation). Antibiotics should be continued until the bulging and discharge have resolved.
  6. Chronic suppurative otitis media (CSOM) should only be diagnosed in children who have persistent discharge through a perforation despite appropriate treatment for acute otitis media with perforation. Effective treatment of CSOM requires a long-term approach with regular dry mopping or syringing of ear discharge followed by the application of topical antibiotics.
  7. All children with persistent bilateral OM (all types) for greater than 3 months should have their hearing assessed.
  8. Families of children with significant hearing loss (>20dB) should be informed of the benefits of improved communication strategies and hearing aids.
  9. Explain to families/caregivers that a child needs to hear people talking in order to learn to talk themselves. Children with OM do not hear well. They will benefit from lots of focussed verbal communication.
  10. Aim to provide patients or families/caregivers with the knowledge to manage their own health needs. Use communication techniques and resources that facilitate true understanding.