Otitis media therapy and drug resistance part 1: Management principles

An ominous increase in resistance to antibiotics among the main pathogens causing acute otitis media (AOM) - particularly Streptococcus pneumoniae - has been recorded worldwide during the last decade. In the past, antibiotic treatment of AOM was hampered by a lack of strict criteria for the selection of appropriate drugs. Such criteria include the age of the patient, the existence of a major group of otitis-prone children who deserve special therapeutic approaches, recent antibiotic use, and the ability of the antibiotic to eradicate pathogens from the middle ear fluid. There is a clear relationship between the minimal inhibitory concentrations of antibiotics for AOM pathogens and their ability to eradicate these pathogens from middle ear fluid.