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November 1973

Ampicillin or Penicillin for Otitis Media: A Controversy Further Clarified-Reply

Author Affiliations

Mayo Clinic and Mayo Foundation Rochester, Minn

Am J Dis Child. 1973;126(5):715. doi:10.1001/archpedi.1973.02110190575030

To the Editor.—Dr. Weinstein points out the problem faced not only by the pediatric house officer but also by all physicians who take care of children with acute otitis media. It is true that the total group of Nilson et al included 306 children, but my comments in the editorial concerned the 67 children in whom transtympanic aspiration yielded Hemophilus influenzae—18 of whom were treated with penicillin alone, 21 with penicillin and a sulfonamide, and 28 with ampicillin. Their evaluation suggested that results were unsatisfactory in 67% of the patients treated with penicillin alone, in 29% treated with penicillin and sulfonamide, and in 29% treated with ampicillin. Even the 29% of unsatisfactory results from ampicillin therapy is hard to understand—the percentage is unusually high. The figures may have been high because reevaluation was done early—on the tenth or 12th day after the beginning of treatment. I believe that evaluation at

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