Commentary: Antibiotic Recommendations for Acute Otitis Media and Acute Bacterial Sinusitis in 2013

The Conundrum

Ellen R. Wald, MD; Gregory P. DeMuri, MD


Pediatr Infect Dis J. 2013;32(5):641-643. 

In This Article


The pathogens that cause acute otitis media (AOM) and acute bacterial sinusitis are well known to primary care practitioners.[1,2] The source of microbiologic data are cultures of middle ear fluid that are obtained by the performance of tympanocentesis, a procedure that can be safely undertaken in the office setting after specific training of clinicians, and with appropriate measures to manage pain for the child.[3,4] Unfortunately, in contrast to AOM, there has been very little study of the microbiology of acute bacterial sinusitis as this requires a more invasive procedure usually performed by pediatric otolaryngologists under local or general anesthesia.[4] Two publications in the early 1980s described the microbiology of acute bacterial sinusitis in children in the United States, based on the results of maxillary sinus aspiration.[5,6] Subsequently, discussions of the microbiology and recommendations for antibiotic management of acute bacterial sinusitis have leaned heavily on recommendations and data developed for AOM.[1]