Antibiotic treatment for acute otitis media

The major problems encountered in the antibiotic therapy of acute otitis media (AOM) are the tremendous increase in the resistance to antibiotics of its main pathogens and the lack of tight criteria (taking into consideration, as a major determinant, the eradication of the pathogens from the middle ear fluid) in the selection of the appropriate antibiotic drugs for the treatment of this disease. Future drugs for the treatment of AOM will have to be approved only after their in vivo microbiological efficacy for each major pathogen is documented. This documentation will be provided by more antibiotic studies with bacteriological outcome using the double- tympanocentesis method and stratifying the AOM patients by age and initial clinical severity. Judicious use of antibiotics for the treatment of AOM will have a major impact on society, leading to a less frequent but more skilled administration of the most effective drugs. (C) 2000 Elsevier Science B.V. and International Society of Chemotherapy.