A wait-and-see antibiotic prescription can be provided at the initial visit with instructions for the caregiver to initiate antibiotics if the child worsens or fails to improve within 3-4 days. Indications for Abx are:
- Bilateral AOM in <2 years
- AOM with perforation/ear discharge
- Recurrent AOM
- Craniofacial abnormalitites
- Immunocompromised
- Systemically unwell
- Infants <6/12 old
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