Child has ear infection and failed numerous rounds of antibiotics to clear it up at what point she need to be admitted for iv antibiotics?

Need ENT Consult: After repeated Ear infections ,there can be fluids behind Tympanic membrane .that can cause hearing impairment and repeated ear infections.over use of antibiotics can cause resistance to antibiotics.Ear tube is one possibility and for that child need ENT consult.

Ear infection: try IM ceftriaxone for two doses on two consecutive days. If that fails and there is pus draining from the ear along with fever or the presence of clinical mastoiditis ( redness, swelling and tenderness over the mastoid bone) then consider IV abx

Admission?: No admission needed for OM unless pt is septic. You can give ceftriaxone intramuscular in the office if oral abx not effective

Never: If the kid has failed at multiple rounds of antibiotics & the process has lasted 60 plus days, the mucus behind the ear drum is likely so thick that NO ANTIBIOTIC will get through & cure it. The treatment would be opening the drum, suctioning out all the debris & leaving a tube in place to keep the drum open while the middle ear space heals. If you are at that point consult an ENT.