Antimicrobial treatment of otitis media: penicillins, cephalosporins, sulfonamides.

Otitis media continues to be one of the most common diagnoses made in the offices of family physicians, pediatricians, and otolaryngologists. The emergence of ampicillin resistant Hemophilus influenzae as an important etiologic agent for otitis media has altered the selection of a therapeutic antimicrobial drug. This article reviews the role of the penicillins, cephalosporins, and sulfonamides in the treatment of otitis media. Amoxicillin continues to be the drug chosen for the uncultured otitis media. Backup drugs for use in unresponsive cases include trimethoprim-sulfamethoxazole, erythromycin-sulfisoxazole, and cefaclor. The cost of the drug should be a factor in the selection when efficacy is equal.