Referral criteria from primary care - suppurative OM

Indications for referral include:

• five episodes of acute otitis media over the winter months, or six episodes in a year
• uncertainty about the diagnosis
• acute otitis media associated with serous otitis media which has not responded to medical therapy
• immediate referral for specialist review is required if complications such as mastoiditis or facial paralysis (1)

Referral may be advisable in persons with craniofacial abnormalities (1).

Reference:

• (1) British Columbia Medical Association (2004) Acute otitis media (AOM). British Columbia Medical Association.
• (2) BMJ (1997);315:98-102.
• (3) BMJ (1997), 315, 321-2.
• (4). BJGP 1998 ; 48 : 1861-64.