This is the first antibiotic I would use, and my second line is

This is the percentage of children who will not improve without treatment and this is the number needed to treat

Signs of a middle ear effusion
Signs of middle ear inflammation
Acute onset of symptoms

Observation for 48 h to 72 h without antimicrobial agents is appropriate in the following instances:
1) Age > 6m
2) Child is healthy and does not have: anatomical abnormalities of the head or neck, OR a history of complicated otitis media OR T21
3) The il

Non typeable H influenzae