The most common pathogens leading to the development of otitis media are the bacteria pneumococcus, Haemophilus influenzae, moraxella. In this regard, antibiotics for otitis media in adults are a priority treatment in many cases, due to the reasons for the development of this disease.
However, the decision on the need for antibiotic treatment for otitis media should be balanced, since there is evidence of self-cure for the disease in the overwhelming majority of cases. At the same time, their incorrect appointment, the use of inappropriate dosages, non-compliance with the duration of admission can lead to a worsening of the condition, delay in treatment and other side effects caused by the intake of these funds.
Indications
The course of otitis media can be complicated by such severe pathologies as labyrinthitis, leading to hearing loss, mastoiditis, meningitis, as well as brain abscess, sepsis, diseases that can cause death. This makes taking antibiotics to be considered an important therapy.
Without fail, they turn to antibiotic therapy if, after 2 days of alternative treatment, there is no positive trend.
Factors to consider when choosing a drug
The choice of the drug, in addition to sensitivity to antibiotics, is also due to the fact that this disease can be acute and chronic, by the nature of the inflammation - catarrhal, serous or purulent. Otitis media can occur with or without perforation of the tympanic membrane. The choice of the necessary drug is also influenced by the fact that antibiotics used for treatment can be in the form of injections, tablets or in the form of ear drops. In addition, there are combined dosage forms, which, in addition to antibiotics, include non-steroidal anti-inflammatory drugs or corticosteroids.
The need for antibiotic treatment for otitis media is due to the symptoms of the disease. The severity of the patient, the degree of intoxication, and the presence of suppuration are very important for determining the therapeutic tactics and clarifying the drug. Perforation of the tympanic membrane, and as a result, suppuration, may be one of the manifestations of the development of a purulent process that needs mandatory correction with antibacterial agents. However, the absence of otorrhea does not always indicate catarrhal or serous otitis media, since the evacuation of the resulting pus can be carried out not due to perforation of the tympanic membrane, but through the auditory tube.
The presence of a symptom of suppuration is important for the choice of the antibiotic dosage form used in this case.
In the absence of otorrhea, antibiotic ear drops are not indicated, since the integral tympanic membrane does not allow the drug to pass to the site of the disease.
In this case, tableted or injectable drugs are preferable, and sometimes their combination, which allows you to achieve the fastest possible effect.
Antibiotic rules
When prescribing antibiotic therapy, it is necessary to comply with the conditions for prescribing this group of drugs. The course of treatment should be at least 7 days, despite the fact that symptoms such as pain and tinnitus, intoxication phenomena often decrease by the second day. Premature discontinuation of medication can lead to a return of the disease and its transition to a chronic form. It is also important to observe the frequency of taking antibiotics.
In addition, when specifying the drug, it is necessary to remember about the presence of a number of antibiotics that have an ototoxic effect. These include drugs of the aminoglycoside group, gentamicin, neomycin, polymyxin B, the action of which leads to receptor damage, and as a result, the development of hearing loss or even deafness.
Recommended drugs
The most effective drugs used in the treatment of this pathology are drugs of the ampicillin group (amoxicillin, Flemoxin solutab, Ranoxil). In this case, ampicillin cannot be used due to its low bioavailability (30% versus 90% amoxicillin). If there is no effect within three days from the start of taking the drug, it is replaced with an antibiotic, which is a compound of amoxicillin with clavulanic acid (Augmentin, Amoxiclav), or cephalosporins (Ketocef, Super, Zinnat).
The reserve drugs include fluoroquinolones. They are used for a prolonged course of the disease, when the previous remedies were ineffective. It is generally accepted that this tactic of prescribing antibiotics for otitis media in adults is considered: augmentin or amokiklav at a dosage of 875 mg 2 times a day or 625 mg three times. If a positive trend appears within two days, the drug must be continued. Recommended 
the dosage is 625 mg twice a day. In the absence of positive dynamics, the drug is replaced with levofloxacin or sparfloxacin.
The choice of an antibiotic for otitis media also depends on whether the disease is acute or chronic.
In the case of an acute course, the symptoms of the disease decrease within 5-7 days.
In this case, while continuing to take antibiotics, it is necessary to carry out measures aimed also at restoring hearing.
Features of the chronic course
Treatment of chronic otitis media has its own characteristics, due to the following:
- the disease can last for many months or years;
- in the process of examining and carrying out bacterial inoculation, several pathogens can be identified, which forces the selection of drugs, taking into account the sensitivity of microorganisms to them and the interaction of drugs with each other;
- the cause of the development of the pathological process may be Proteus or Pseudomonas aeruginosa, which greatly complicates the choice of medicines;
- due to the long course of the disease, oral or parenteral agents can be prescribed only in the acute period or postoperative course;
- this course of the disease involves the use of agents in the form of drops, fluids for washing the ear cavity, ointments.
In this regard, in addition to the funds used in the acute course of the process, the chronic form of otitis media implies the additional use of drugs that also have an effect on Pseudomonas aeruginosa and Escherichia coli, Salmonella, Proteus. Such antibiotics for otitis media used in the chronic course of the process are ciprofloxacin, chloramphenicol.
As for determining the sensitivity of microflora to an antibiotic, in the case of an acute course of the process, this may not be necessary, since the duration of the disease itself is as long as the study will continue. Besides 
In addition, suppuration is not an obligatory sign of the disease, therefore, the content for research can only be obtained during surgery.
However, the chronic course of the disease implies that this research method must be carried out, since the nature of the pathogens in this case may be different, which will significantly complicate the choice of the drug. In addition, given the role of antibiotics in reducing the body's immunity, their choice should be carefully justified.In this case, it is impossible to reduce the importance of immunostimulating drugs, as well as measures aimed at increasing the patient's immunity.
Thus, in the event that there are no results of a bacteriological study of microflora for sensitivity to antibiotics, preference is given to amoxicillin or its derivatives in tablet forms. Antibiotic therapy can be started 2 days later after the absence of positive dynamics from the use of other means and methods of treatment. Before that, anti-inflammatory and analgesic drugs for external action, antiseptic agents, and thermal procedures can be used.
Decide on the tactics of what antibiotics are needed for otitis media, should an otolaryngologist. A specialist who has in his arsenal methods of objective examination of the patient will be able to clarify the diagnosis and prescribe the correct treatment. At the same time, similar symptoms may be characteristic of a disease caused by a virus. The appointment of antibacterial drugs in this case is incorrect.
