Antimicrobial therapy for acute otitis media.

The management of acute otitis media is made more rational by consideration of the in vitro susceptibilities of the common pathogens, penetration of drug into middle ear fluid and results of comparative clinical efficacy trials. The emergence of beta-lactamase-producing Haemophilus strains and the finding that B. catarrhalis is a frequently encountered beta-lactamase-producing organism in some areas of the country emphasize the importance of delineating the cause of disease in children with acute otitis media. Because of the many variables that confound the response to therapy, each patient must be carefully followed and the regimen altered if the clinical response is unsatisfactory.