Follow up

Patients should be seen in 48 to 72 hours to assess for changes in the condition and action can proceed with the corresponding management:

• For children treated with observation, ensure follow-up and begin antibiotic therapy if symptoms worsen or fails to improve
• For children treated with antibiotics, reassess for reports on symptoms and if the therapy has failed to determine if a change in treatment course is needed

Children who improve can be followed up in 8 to 12 weeks to ensure complete resolution of any residual effusion and other long-standing symptoms. Middle ear effusion persists 60-70% at 2 weeks, 40% at 1 month, and 10-25% at 3 months after successful antibiotic therapy.

Patients with complications need ear, nose, and throat (ENT) referral.