Antimicrobial sensitivity for many kinds of antibiotics was studied from strains cultured from middle ear effusions of patients with accute purulent otitis media. From these results, when these patients are treated with antibiotics, the choice of antibiotics was discussed. The results are as follows: 1) In fresh cases without spontaneous perforation of the tympanic membrane, streptococcus pneumoniae, Hemophilus influenzae and beta-streptococci are predominant causative bacteria. They comprise about 95% of the causative pathogen of acute purulent otitis media. So in these cases, ampicillin (ABPC) is the first-choice antibiotic. However, if ampicillin (ABPC) shows no therapeutic effect after 3 days following drug administration, the causative pathogen may be staphylococcus aureus. The second-choice antibiotic is cephalexin (CEX). 2) In cases with spontaneous perforation of the tympanic membrane and otorrhea, streptococcus pneumoniae, Hemophilus influenzae and staphylococcus aureus are found predominantly in middle ear discharge. Ampicillin (ABPC) or erythromycin (EM) is the first-choice antibiotic and cephalexin (CEX) is the second-choice antibiotic in these cases. 3) When the patient complains of a drug allergy to penicillin or cephalosporin, erythromycin (EM) is the first choice and tetracycline (TC) is the second-choice antibiotic.
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