Over a 1-year period, a diagnosis of suppurative otitis media was made in 21 infants less than 6 weeks of age, with symptomatology varying from mild rhinorrhea and cough to irritability and severe, protracted diarrhea. Only four infants presented with fever greater than 38°C. One-third of the patients had been born prematurely, 90% were bottle-fed, and only two had significant congenital malformations. Two-thirds of the babies with otitis of bacterial origin were male.

Infants admitted to the study underwent diagnostic tympanoparacentesis, yielding purulent material and bacterial growth from all but three. The predominant organisms isolated were Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae. In cases of treatment failure, reinfection was most common with Pseudomonas aeruginosa. On the basis of disc sensitivities, only 61% of the exudates from which bacteria were isolated proved amenable to ampicillin therapy alone. Bacteria cultured from nasopharyngeal swabs of the same infants showed a correlation with ear isolations in only 28% of the cases. When a 10-day course of therapy was carried out utilizing antibiotics to which the organism was sensitive, there was a 22% failure rate, suggesting the possible need for more prolonged therapy with a parenterally-administered agent plus ampicillin in the management of otitis media in the neonate and young infant.

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