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In addition, those with otitis externa can experience a continuous or intermittent discharge. Intermittent discharge occurs in children with recurrent acute otitis media, but some patients with a perforated eardrum can have a continuous or intermittent sticky discharge. Prolonged discharge can occur in patients with otitis externa, but other conditions, such as cholesteatoma (skin growing in the wrong place), may need to be considered. In children, severe pain that reduces with the onset of the discharge may be a sign of acute otitis media.

Some patients may only experience discharge for a few hours. Table: Questions that can help pharmacists and their teams have impactful consultations with patients presenting with ear discharge, pain or dizziness “I have some discharge from my ear” Pharmacists with independent prescribing capabilities could prescribe and dispense medicines directly to the patient, when appropriate, thereby reducing the burden on GPs and ensuring treatment is started earlier for the patient. Pharmacists having an increased understanding of conditions that commonly affect the ear, as well as an awareness of symptoms that may indicate a potentially rare or more serious diagnosis, will enable some patients with ear problems to be appropriately managed without a referral. The extended role of the pharmacist, particularly in the community or within GP surgeries and acute medical assessment units, is an exciting development. A patient may complain of a specific symptom, but asking about any co-existing issues will allow the pharmacist to determine the most likely cause and, therefore, the suitable treatment. The main questions that will help pharmacy teams have impactful consultations with patients presenting with ear symptoms are included in the Table.

This article provides a framework to aid the diagnosis and appropriate management of ear discharge, earache, dizziness, vertigo and imbalance, based on patient symptoms and the limited examination that can be performed in a pharmacy. However, because patients do not present directly to the pharmacist in every interaction in the pharmacy, the entire pharmacy team should be aware of what they can do to help. It is common for patients to present to the community pharmacy complaining of an issue with their ears