Selection of antimicrobial agents for treatment of acute otitis media with effusion

Although a few studies suggest that symptomatic treatment alone may be sufficient for many children with acute otitis media with effusion, most investigators believe that clinical response is improved with antibiotic therapy. The first step in selecting an antimicrobial agent for treatment of acute otitis media with effusion is to determine in vitro susceptibilities of the most frequently isolated pathogens to commonly used antibiotics. Another important variable to consider is the degree to which the prospective agent penetrates and is concentrated in middle ear fluid. Although bacteriologic eradication of causative pathogens remains an objective of therapy, the desired result of any treatment regimen for both physician and patient is a satisfactory clinical response. Knowledge of geographic bacterial resistance patterns is essential to effective antibiotic therapy and continued successful clinical outcomes. The ideal antimicrobial agent for treatment of acute otitis media with effusion is safe, well-tolerated by infants and young children, is effective against the most frequently encountered pathogens and is affordable.