Penetration of Various Antibiotics into the Middle Ear

Abstract

In spite of the enormous body of literature on different aspects of otitis media, there have been surprisingly few studies dealing with the important problems of antibiotic penetration into the middle ear. As late as 1966, when Silverstein et al. [1] published their article in Pediatrics, they could begin with the words: ‘To date, there has been no proof that antibiotics reach the middle ear in effective concentrations during the course of active inflammation in that area’. This pioneer work resulted in further research on the penetration of different antibiotics in acute otitis media and secretory otitis media [2–4]. However, most investigations deal with the penetration in the input phase, and often in a small number of cases. In 1979, a larger study was published, which described characteristics of the penetration of an antibiotic through the middle-ear mucosa, not only in the first period after administration of the drug (input phase) but also in two subsequent periods, the steady-state phase and the output phase [5].