Earache treatment through NHS Pharmacy First
Earache can leave children uncomfortable, restless and struggling to sleep. At Lemonpill in Coventry, our Pharmacy First service provides professional assessments for children with suspected middle ear infections, helping families access advice and treatment without seeing a GP first.
- For children aged 1 to 17. NHS Pharmacy First assessments for suspected acute middle ear infections.
- No GP referral needed. Book directly with our pharmacy team for an assessment.
- Free NHS consultation. Treatment may include advice, pain relief or prescription medicines when clinically appropriate. Normal NHS prescription charges and exemptions apply.
How your Pharmacy First consultation works
Our pharmacist follows the NHS clinical pathway for acute otitis media, also known as a middle ear infection. The consultation is designed to identify the likely cause of your child’s symptoms and recommend the most appropriate care.
- Discuss the symptoms. We will ask when the earache started, which ear is affected, whether your child has a fever or hearing changes, and about any medicines, allergies or previous infections.
- Examine the ear. The pharmacist will use an otoscope, a small instrument with a light, to examine the ear canal and eardrum. This helps identify signs of infection or other possible causes of pain.
- Agree on treatment. Depending on the examination, your child may receive self-care advice, suitable pain relief, prescription ear drops or antibiotics when the clinical criteria are met. If necessary, we will recommend further medical assessment.
Does every ear infection need antibiotics? No. Most uncomplicated middle ear infections improve without antibiotics, often within 2 to 3 days, although some symptoms can last around a week. The pharmacist will only recommend antibiotics when they are likely to provide a clinical benefit.
Book an earache consultation
Arrange an NHS Pharmacy First assessment with Lemonpill for your child, aged 1 to 17. Your child must attend the pharmacy so the pharmacist can examine their ear in person.
Before booking: Check the urgent-care advice above. A routine appointment is not suitable for serious or rapidly worsening symptoms.
Having trouble booking? Contact our pharmacy team for assistance.
Signs and symptoms of earache in children
Earache may cause sharp, dull or throbbing pain in one or both ears. Older children can often describe the discomfort, while younger children may show changes in their behaviour.
Common signs include:
- Rubbing, holding or pulling at an ear
- Crying more often, irritability or restless sleep
- A temperature of 38°C or above
- Reduced appetite or difficulty settling
- Muffled hearing or not responding to sounds normally
- Feeling of pressure or fullness inside the ear
What causes earache?
A common cause is acute otitis media, an infection behind the eardrum. It often follows a cold when inflammation and trapped fluid cause pressure and pain inside the middle ear.
Other causes include outer ear infections, earwax build-up, glue ear, sore throats, dental problems and pressure changes. These conditions can produce similar symptoms but may need different treatment.
Not all earache is caused by an infection. An examination helps the pharmacist decide whether the Pharmacy First middle ear infection pathway is suitable.
What treatment can Pharmacy First provide?
The treatment recommended will depend on your child’s age, symptoms, medical history and examination findings. Our pharmacist will explain the available options and why a particular approach is appropriate.
- Pain relief: Age-appropriate paracetamol or ibuprofen may help manage ear pain and fever. The pharmacist can advise on suitable medicines and doses.
- Prescription ear drops: Some children may benefit from phenazone and lidocaine ear drops for pain relief. These are only suitable in certain circumstances and must not be used if the eardrum is perforated or there is ear discharge.
- Antibiotics: If the NHS clinical pathway indicates that antibiotics are appropriate, the pharmacist may supply a suitable medicine, such as amoxicillin or an alternative where clinically indicated.
- Further medical care: Children with concerning symptoms, certain underlying conditions or infections outside the service criteria may be referred to a GP or another healthcare service.
Treatment is not guaranteed. Sometimes the safest and most effective outcome is advice on managing symptoms while the infection clears naturally.
Helping your child feel better at home
Most uncomplicated ear infections improve within a few days. While your child recovers, simple measures can help reduce discomfort.
- Manage pain safely. Use children’s paracetamol or ibuprofen when suitable, following the packet instructions. Never give aspirin to anyone under 16.
- Try a warm flannel. Gently holding a comfortably warm flannel against the affected ear may provide temporary relief.
- Encourage rest and fluids. Offer regular drinks, keep your child comfortable and allow them to rest when needed.
- Keep the ear dry. Avoid swimming and prevent water or shampoo entering the affected ear during recovery.
- Avoid putting anything inside the ear. Do not use cotton buds, attempt to remove earwax or apply unprescribed ear drops or household remedies.
When should symptoms improve? Many children start feeling better within 2 to 3 days, although complete recovery may take about a week. If symptoms are not improving, persist beyond 2 to 3 days or become worse, seek further medical advice.
When might your child need a GP?
Although Pharmacy First can treat many uncomplicated middle ear infections, some symptoms require further investigation.
Contact a GP if your child experiences repeated ear infections, persistent hearing difficulties or earache that keeps returning. A GP can assess whether further examination or specialist care is necessary.
Recurring infections: Children with 3 or more episodes of acute otitis media within 6 months, or 4 or more episodes within 12 months, are excluded from the Pharmacy First acute otitis media treatment pathway.
If your child has already started antibiotics and symptoms have not improved after 2 to 3 days of treatment, arrange reassessment. Seek help sooner if they become very unwell or symptoms worsen significantly.
Earache treatment FAQs
Find quick answers to common questions about using Pharmacy First for children’s earache.
Who can use Pharmacy First for earache?
The NHS acute otitis media pathway is available for eligible children and young people aged 1 to 17. You do not need a GP referral, and your child does not have to be registered with a GP to access the service. The pharmacist will confirm eligibility during the assessment.
Can my child receive antibiotics from the pharmacy?
Yes, if the pharmacist confirms that antibiotics are clinically appropriate under the NHS pathway. Many ear infections clear without them, so self-care advice or suitable pain relief may be recommended instead.
Can the consultation take place over the phone?
No. This Pharmacy First pathway requires a face-to-face examination using an otoscope. Your child must attend the pharmacy so the pharmacist can assess the ear properly.
Is the Pharmacy First consultation free?
Yes. Eligible NHS Pharmacy First consultations are free. Normal NHS prescription charges apply where relevant, although children under 16 and qualifying 16 to 18-year-olds in full-time education are exempt. Over-the-counter products purchased separately must be paid for.
What if Pharmacy First treatment is not suitable?
The pharmacist will explain the next steps and direct you to an appropriate service, such as your GP, NHS 111 or urgent care. Where your child is registered with a GP, information about the consultation is sent to the practice to update their health record.
Get help with your child’s earache
If your child has ear pain or symptoms of a suspected middle ear infection, Lemonpill in Coventry is here to help.
Our pharmacist can examine the ear, recommend appropriate treatment and explain when further care may be needed.
Book your Pharmacy First earache consultation
For assistance, contact Lemonpill, based in Islington, London.
This information is for general guidance and does not replace an individual clinical assessment. NHS Pharmacy First treatment for acute otitis media depends on eligibility, symptoms, examination findings and medical history. Seek urgent medical advice for severe, worsening or concerning symptoms.