I am pleased that Dr. Field's experience with throat cultures has been rewarding, and I know that many other pediatricians have found them equally useful. Apparently Dr. Roberts disagrees. It is perfectly true that a single culture may not yield all the information one would like, but one throat culture is surely better than none.
I would agree with both correspondents that it is not possible often to isolate the causal agent from a nasopharyngeal culture in children with otitis media. However, we have seen enough infants with otitis in whom a relatively pure culture of Hemophilus influenzae or pneumococci was obtained, to suggest that this nasopharyngeal culture should not be discarded altogether. We still prefer penicillin for pneumococcal infections, but I would agree with the suggestion made by both contributors that for H. influenzae infections tetracycline is preferable to chloramphenicol as the starting drug. However, we have treated infants