I believe that amoxicillin continues to be the drug of choice for therapy for acute otitis media. Ceftriaxone may be an alternative for selected patients. The following points are important in response to Dr Semones' comments:
Ceftriaxone is not currently approved by the Food and Drug Administration for treatment of acute otitis media.
If and when it is approved, its use should be considered for specific clinical circumstances, such as acute otitis media in a young infant who may also have bacteremia.
Selective use of oral antibiotics for all indications should be fostered.
We are unaware of any data that indicate that a single dose of ceftriaxone is more likely to foster development of resistant pathogens than a 10-day course of an oral antibiotic approved for therapy for acute otitis media.