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Aggregate evidence quality: B; randomized controlled trials with limitations.
Benefit Increase clinical cures, shorten illness duration, and may prevent suppurative complications in a high-risk patient population. 
Harm Adverse effects of antibiotics. 
Cost Direct cost of therapy. 
Benefits-harm assessment Preponderance of benefit. 
Value judgments Concern for morbidity and possible complications if untreated. 
Role of patient preference Limited. 
Intentional vagueness None. 
Exclusions None. 
Strength Strong recommendation. 
Aggregate evidence quality: B; randomized controlled trials with limitations.
Benefit Increase clinical cures, shorten illness duration, and may prevent suppurative complications in a high-risk patient population. 
Harm Adverse effects of antibiotics. 
Cost Direct cost of therapy. 
Benefits-harm assessment Preponderance of benefit. 
Value judgments Concern for morbidity and possible complications if untreated. 
Role of patient preference Limited. 
Intentional vagueness None. 
Exclusions None. 
Strength Strong recommendation. 
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