A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute otitis media is seen for follow-up. The primary care nurse practitioner notes dull-gray tympanic membranes with a visible air-fluid level. The child is afebrile and without pain. What is the next course of action?

Choice A reason: Ceftriaxone is used for severe or refractory acute otitis media, not for asymptomatic otitis media with effusion (OME). The child is afebrile and pain-free, making this option inappropriate. Choice B reason: Short-term watchful waiting is used for acute otitis media, not for OME. The presence of fluid without symptoms suggests a chronic process. Choice C reason: OME often resolves spontaneously within 3 months. Monitoring during this period is appropriate unless hearing loss or developmental concerns arise. Choice D reason: Clindamycin is not indicated for OME and is typically reserved for resistant bacterial infections. There is no evidence of active infection in this case.