In Vivo Sensitivity Test in Otitis Media: Efficacy of Antibiotics

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Abstract
During a 10-yr period, antibiotics were assigned in random, double-blind fashion in 6 combinations to treat 948 episodes of otitis media in children. Exudate from the middle ear of all patients was cultured before treatment. Three follow-up visits were conducted: the 1st follow-up visit was 3-5 days after the start of therapy and the 2nd and 3rd visits were 14 and 31 days after onset of treatment. Exudates were recultured for 75% of the patients on the first follow-up visit. Comparison of treatment results showed that triple sulfonamide combined with either phenoxymethyl penicillin, or benzathine and procaine penicillin G given i.m. was as effective as was ampicillin or amoxicillin. Phenoxymethyl penicillin and cyclacillin alone were usually effective against pneumococci but relatively ineffective against Haemophilus influenzae. Cefaclor and trimethoprim-sulfamethoxazole produced unsatisfactory results in about 1/2 the cases caused by pneumococci or H. influenzae. Although production of .beta.-lactamase by some otitis-causing Haemophilus and Staphylococcus species may explain the ineffectiveness of some treatments, the percentage of organisms positive for .beta.-lactamase was too small to be responsible for the poor results with certain drugs.