Outcome evaluation

Improvement of signs and symptoms (i.e., pain, fever, and tympanic membrane inflammation) should be evident by 72 hours of therapy. Children can appear clinically worse during the first 24 hours of treatment but often stabilize during the second day with defervescence and improved eating and sleeping patterns. If symptoms persist or worsen, reevaluation must occur to determine the proper diagnosis and treatment.

Counsel patients and caregivers regarding common antibiotic adverse events such as rash, diarrhea, and vomiting that may prompt additional medical attention.

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