An 18­month­old Child with No Previous History of Otitis Media

An 18­month­old child with no previous history of otitis media awoke during the
night with right ear pain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F and an erythematous, bulging tympanic membrane. A tympanogram reveals of peak of +150 mm H2O. What is the recommended treatment for this child?

A) Amoxicillin 80 to 90 mg/kg/day in two divided doses
B) An analgesic medication and watchful waiting
C) Ceftriaxone 50 to 75 mg/kg/dose IM given once
D) Ototopical antibiotic drops twice daily for 5 days