A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes
The child is taking fluids well and is playing with toys in the examination room. The NP should: a. prescribe azithromycin once daily for 5 days.
b. prescribe amoxicillin twice daily for 10 days.
c. prescribe amoxicillin-clavulanate twice daily for 10 days.
d. initiate antibiotic therapy if the child's condition worsens.
D
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a low-grade fever, no history of otitis media, a nonbulging tympanic membrane, and no otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is the drug of choice.
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