[Dr.Vad]

deciding who can be safely treated without empirical antimicrobial therapy must depend somewhat on clinical judgement but should also include objective criteria such as length and severity of illness. Children who have a mild or moderately bulging TM, and who are mildly ill, alert, responding to antipyretics, have a low-grade fever (<39°C) and mild otalgia can be safely managed with an observation or ‘watchful waiting’ period of 24 h to 48 h. Planned reassessment, access to timely reassessment or “expectant” antimicrobial prescriptions may be acceptable approaches, depending on clinical and social circumstances. Children with AOM (defined by a bulging TM) who are highly febrile (≥39°C) and moderately to severely systemically ill, or children who have severe otalgia or have been significantly ill for 48 h should be treated with antimicrobials.
[Ссылки доступны только зарегистрированным пользователям ]