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Ampicillin or Penicillin for Otitis Media: A Controversy Further Clarified

Am J Dis Child. 1973;126(5):714. doi:10.1001/archpedi.1973.02110190575028.
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To the Editor.—The recent editorial comment by Dr. Stickler (125:403, 1973) regarding the study of Bass and Associates (125:397-402, 1973) in which he advocates the use of penicillin rather than ampicillin as the initial drug of choice in acute otitis media even where the causative organism might be Hemophilus influenzae does not seem justified by the available data.

The study of Nilson et al,1 the only one in which clinical results of penicillin vs ampicillin were compared in cases of H influenzae otitis media showed ampicillin to be more effective. This study was mentioned by Dr. Stickler, but, rather surprisingly, he omitted discussing the one of Howie and Ploussard,2 which strikingly showed that the theoretical advantage of ampicillin as determined by in vitro sensitivity tests was, in fact, true in vivo. In 14 cases of H influ-


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