ACUTE OTITIS MEDIA: TREATMENT RESULTS IN RELATION TO BACTERIAL ETIOLOGY

Abstract

Three hundred and six children less than 3 years of age with acute otitis media were randomly distributed among three oral treatment regimens: penicillin V, penicillin V plus sulfonamide, and ampicillin. Treatment groups were comparable when analyzed for the number of patients with fever at onset and the proportion shown to be taking the antibiotic by blood assay. Response was determined in a double blind manner and correlated with the organism isolated from the middle ear aspirate. Results both for pneumococcal otitis and for all otitis regardless of culture were not significantly different with the three regimens. However, the groups with H. influenzae otitis treated with either penicillin plus sulfonamide or ampicillin had a better therapeutic response than those treated with penicillin V alone. Patients receiving ampicillin generally achieved a bacteriostatic serum level for strains of H. influenzae isolated by tympanocentesis while patients receiving penicillin V generally did not achieve such a level.