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Acute Otitis Media (Pharmacy First)

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0>=1>=10>=10>=10YesNoYesNoMildModerate/SevereYesNoNo penicillin allergyPenicillin allergyNot pregnantPregnant>=10No penicillin allergyPenicillin allergyPregnantNot pregnant
Outcome

Supply amoxicillin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_amoxicillin outcome info
Question

Reported penicillin allergy (via National Care Record or Patient/Carer)?

allergy_check decision select
Question

Screen for emergency symptoms and serious complications. Select ANY that apply.

emergency_screen decision select_multiple
Question

Is the patient pregnant (aged 16–17)?

pregnancy_check decision select
Outcome

Supply clarithromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_clarithromycin outcome info
Outcome

Supply erythromycin for 5 days.

outcome_erythromycin_4 info
Question

Shared decision making — does the patient have severe symptoms or symptoms for more than 3 days?

shared_decision decision select
Outcome

Supply erythromycin for 5 days.

outcome_erythromycin outcome info
Question

Symptom check- does the patient have the following symptoms? Select ANY that apply.

symptom_screen select_multiple
Outcome

AOM less likely — symptomatic findings do not support diagnosis. Consider alternative diagnosis and proceed appropriately.

outcome_not_aom_copy info
Outcome

For moderate-severe ear pain with intact eardrum. Symptomatic relief only — does not treat the underlying infection. Supply phenazone 40mg/g + lidocaine 10mg/g ear drops for up to 7 days. Plus self care.

outcome_ear_drops_copy_0 info
Outcome

Supply amoxicillin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_amoxicillin_copy_1773430314669_0 info
Question

Reported penicillin allergy (via National Care Record or Patient/Carer)?

allergy_check_copy_1773430314738_1 select
Question

Is the patient pregnant (aged 16–17)?

pregnancy_check_2 select
Outcome

Supply clarithromycin for 5 days (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_clarithromycin_3 info
Referral

Patient is not eligible for this pathway. Refer to prescriber or appropriate service.

outcome_not_eligible referral info
Question

Is the patient eligible for the Acute Otitis Media pathway? Select ANY that apply

eligibility decision select_multiple
Referral

Urgent: call 999 or signpost patient to A&E immediately. Emergency red-flag features identified. Consider calculating NEWS2/PEWS Score.

outcome_emergency referral info
Outcome

AOM less likely — otoscopic findings do not support diagnosis. Consider alternative diagnosis and proceed appropriately.

outcome_not_aom outcome info
Question

Acute otitis media more likely, offer self care and regular pain relief to all patients. Does the patient have the following complications? Select ANY that apply.

complication_screen checklist select_multiple
Referral

Onward referral — General practice or other provider as appropriate. Patient has complications requiring prescriber assessment.

outcome_complication_referral referral info
Question

Does the child/young person have otorrhoea (discharge after eardrum perforation) or eardrum perforation (suspected or confirmed)

otorrhoea_check decision select
Question

Is the child under 2 years AND with infection in both ears?

bilateral_check decision select
Question

Assess symptom severity.

symptom_severity decision select
Outcome

Self-care and pain relief.

outcome_self_care outcome info
Outcome

For moderate-severe ear pain with intact eardrum. Symptomatic relief only — does not treat the underlying infection. Supply phenazone 40mg/g + lidocaine 10mg/g ear drops for up to 7 days. Plus self care.

outcome_ear_drops outcome info
Question

Otoscopic examination — does the patient have the following findings? Select ANY that apply

otoscopy checklist select_multiple
Info

Patient presenting with signs and symptoms of acute otitis media. Press next to continue.

intro_guidance info_panel info

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