Acute Otitis Media - Pharmacy First

Pharmacy First clinical pathways required criteria [1]:

• must be aged 1-17 years old

Exclude:

• 3 or more episodes in the last 6 months

• 4 or more episodes in the last 12 months

• pregnant individuals who are under 16 years of age (16-17 year old pregnant individuals are included in the service)

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Red flags (signpost to A&E or call 999 in life-threatening emergency):

• Meningitis - neck stiffness, photophobia, mottled skin

• Mastoiditis - pain, soreness, swelling, tenderness behind the affected ear(s)

• Brain abscess (severe headache, confusion or irritability, muscle weakness)

• Sinus thrombosis (headache behind or around the eyes)

• Facial nerve paralysis

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If no red flags, peform otoscopy. Patient has now passed Gateway Criteria to enter the service.