Proper use of antibiotics in treatment of acute otitis media.

The problem of preventing loss of hearing following acute otitis media has been made more complex by the use of penicillin and other antibiotic agents which may apparently cure yet leave dangerous residual disease. The causes of loss of hearing must be recognized early if remedial treatment is to be effective. In children particularly, loss of hearing may go unnoticed for some time. Physicians who treat otitis media should feel the responsibility not only of bringing an acutely ill child back to health but of preserving the function of the hearing mechanism. Careful examination of the ear after apparent subsidence of infection is mandatory. It is of the utmost importance to be able to recognize the ear drum in its normal state and its various pathological states and to be alert to the early signs of changes associated with loss of hearing. Antibiotics should not be expected to do more than help combat the acute infection in otitis media. Adequate follow-up demands strong suspicion of residual pathologic process in the ear. The prevention of loss of hearing still requires knowledge of the established clinical facts and therapeutic procedures and the application of this knowledge to treatment of acute infections of the middle ear.