What is the most appropriate action for a patient with otitis media with effusion who reports that their ear pain has resolved but continues to experience itching and crackling?

In cases of otitis media with effusion (OME), it is not uncommon for ear pain to resolve while other symptoms, such as itching and crackling, persist. The presence of itching and crackling sounds often indicates that fluid remains in the middle ear, but it does not necessarily indicate an active infection or the need for further antimicrobial treatment.

The most appropriate action in this scenario is to reassure the patient that these symptoms often resolve on their own over time. In many cases, OME is self-limiting, especially when there are no signs of a persistent infection, such as fever or significant ear pain. Counseling the patient that resolution may take a few weeks can help manage their expectations and provide comfort as they recover.

Repeating or changing the antimicrobial therapy would not be advised unless there is strong evidence of an ongoing infection, which is not indicated by the resolution of pain. Referral to a specialist would be considered in more complex cases, particularly if the effusion persists over a longer period or if hearing loss develops. However, since the patient is not presenting with urgent or concerning symptoms beyond the described sensations, specialist referral is unnecessary at this stage.