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January 17, 1996

Bacterial DNA Fragments in Otitis Media With Effusion-Reply

Author Affiliations

University of Pittsburgh Pittsburgh, Pa

JAMA. 1996;275(3):186. doi:10.1001/jama.1996.03530270026022

In Reply.  —Dr Cantekin's correspondence addressing the significance of our finding amplifiable DNA in "culturally sterile" pediatric chronic MEEs is the latest in a long line of his dissenting opinions on the topic of antibiotic effectiveness for the medical treatment of otitis media.1 He has incorrectly inferred that we would use the data in our article to recommend increased antibiotic usage. He has chosen to ignore the animal data we referenced2 that demonstrate that the bacterial DNA found in MEEs following antibiotic treatment is most likely associated with viable pathogens and not representative of DNA fragments fossilized in the secretory "glue." The fact that pathogenic bacteria are persisting in a viable, but unculturable, state following antimicrobial therapy would suggest that this treatment modality is not necessarily always effective. Furthermore, we would argue that the persistence of an MEE following therapy might be used as an indicator that other