mrcem2-0366

A 32 year old male who is a type 1 diabetic presents to the emergency department feeling unwell with a 2 day history of right sided earache. The patient’s observations are shown below. On examination, you note the tympanic membrane is bulging and pink. There is no mastoid tenderness or palpable lymphadenopathy in the head or neck. The rest of the examination is unremarkable.

Blood pressure: 128/84 mmHg
Pulse: 82 bpm
Respiration rate: 18 bpm
Temperature: 37.9ºC
Oxygen saturations: 98% on air

What is the most appropriate management?