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156.

A four-month-old girl with trisomy 21 was admitted to Accident and Emergency ward due to fever and vomiting from the previous day. In the evening a day prior to the admission, the patient’s parents observed increased anxiety in the baby, then in the early morning, the anxiety resolved. Later in the morning, purulent discharge from an ear was observed. Otoscopic examination revealed reddening and perforation of the tympanic membrane of the right ear and reddening of the tympanic membrane of the left ear. Indicate the right further management:

A. ibuprofen three times a day, a subsequent otoscopic assessment after 48 hours.
B. ibuprofen three times a day for 48 hours, antibiotic therapy with amoxicillin for 10 days.
C. ibuprofen three times a day, ear drops with a steroid and ciprofloxacin, a subsequent otoscopic assessment after 48 hours.
D. hospitalization, antipyretic treatment, hydration, a subsequent otoscopic assessment after 48 hours.
E. hospitalization, antipyretic treatment, hydration, intravenous administration of cefuroxime for 10 days.

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