Streptococcus Pneumonia 
Haemophilus Influenza 
Moraxella Catarrhalis 
Strains of bacteria, specifically Streptococcus Pneumonia, Haemophilus Influenza and Moraxella Catarrhalis, have become more resistant to conventional antimicrobial treatment for Acute Otitis Media (AOM). Evidence supporting this comes from studies of treatment of children with AOM and the ineffectiveness of the conventional antimicrobial treatment with amoxicillin, ampicillin, etc.
Children under the age of 5 have been found to need a longer period of antimicrobial treatment, usually 10-14 days, to effectively combat the infection and children aged 6 and older tend to recover after a shorter treatment period, usually 5-7 days.
Nonrestrictive use of antimicrobials for treatment of Acute Otitis Media (AOM) in children under the age of six (6) is adding to the prevalence of certain bacterial strains becoming less submissive to popular treatment regimes.
There have been 7 randomized placebo-controlled trails conducted of AOM over the past 30 years. 3 studies demonstrated no short or long-term differences between the placebo-controlled group and the antimicrobial treated group. 4 studies demonstrated only minor short-term benefits of the antimicrobial treated group.
There have been several antimicrobial-controlled trials conducted studying the effects of shorter vs. longer treatments of antimicrobials, 5-7 days rather than 10-14 days. The trial results were mixed. Some of the trials found no differences between the two groups and some favored the groups treated with a longer period of antimicrobials. These particular trials had only a limited sample size, few or no children under the age of 2 and a lack of standardized criteria for testing of AOM.
All trials stressed the importance to restrict antimicrobial treatment do to the compelling evidence of the rising prevalence of infections caused by multi drug resistant bacteria.
These trials conclude that if antimicrobials are given at the presentation of OM, only 20% of the children actually benefited from them. No short or long-term benefits are reported.
Unfortunately, the teams conducting these trials used different criteria to select patients and to measure short and long-term outcomes. Thus making it impossible to distinguish exactly what age groups were being tested and which were being left out.
Evidence that antimicrobials are effective therapy for treating AOM is lacking, it is not surprising that neither type nor duration of administration has been shown to effect outcomes.
What is Acute Otitis Media(AOM)?
It is a medical term for Ear Infections. AOM is an inflammation of the middle ear, often followed by a viral upper respiratory infection. AOM is primarily found in children between the ages of 6 and 12 months, but all children under the age of 10 are susceptible to it. The cause of AOM is due to bacteria that move up though the nasal passage into the middle ear and causes infection. This happens when a child gets a general cold and it is also caused by stomach illnesses. When a young child projectile vomits, sometimes fluid gets pushed up into the middle ear and this creates a great nesting place for bacteria.
AOM is the number one reason for healthcare visits in the U.S. In 1996, there were 27 million office visits due to AOM. Out of the 27 million visits, 24 million antimicrobial prescriptions were filled.
For years doctors have been prescribing antibiotics to children as young as 3 weeks old to combat AOM, and time and time again the same children come back for the same problem. The reasons for the recurrence varies, but most doctors will agree that the constant treatment with antimicrobials is causing certain bacterial strains to get stronger, therefore creating longer and longer treatment patterns in order to combat the bug.
In conclusion, evidence of whether antimicrobial treatment for all cases of AOM is necessary is weak. In certain cases there may be no alternatives and in others it may be questionable. There has not been enough controlled testing done to make the determination as to which age group is effected more, but there has been conclusion by all doctors that non restricted use of the antimicrobial treatments are adding to the problem of resistant strains of bacteria.
Other Websites you can visit to find more information about AOM
Healthy Lives - Ear Infections
What is a Eustachian Tube?
GlaxoWellcome
National Institue of Health
