The nurse practitioner is re-evaluating a 4-year-old child who began amoxicillin for acute otitis media 3 days ago. The nurse practitioner should switch to another antimicrobial if.

Rationale: A. Ear pain alone may persist during the first few days of effective antibiotic therapy and is not an immediate indication to switch antibiotics. B. Persistent redness of the tympanic membrane can also remain for several days, even with effective treatment. C. Mobility of the tympanic membrane during pneumatic otoscopy suggests that fluid is not under high pressure, which is not an indication to change therapy. D. A persistent high fever (≥102°F) after 48–72 hours of antibiotic therapy may indicate treatment failure or infection with a resistant organism. In such cases, the nurse practitioner should consider switching to an alternative antimicrobial or further evaluation.