Occasionally we manage children with chronic suppurative otitis media (CSOM). The link below, to the Clinical Care Guidelines for the Management of Otitis Media in Aboriginal and Torres Strait Islander Populations, is a comprehensive review of what to do for the variety of ear infections we see clinically.

You can safely use dilute (1:20) povidine-iodine (Betadine(R)) to perform ear toilet, for ears where there is perforation, in addition to treatment with a topical antibiotic (e.g. ciprofloxacin 2-5 drops 2-4 times a day after cleaning). Those of us with access to video-otoscopy should also photo-document the size of the perforation if possible.

https://www.health.gov.au/internet/main/publishing.nsf/Content/B8A6602C7714B46FCA257EC300837185/%24File/Recommendation-for-clinical-guidelines-Otitis-Media.pdf