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Abstract
Eightynine children with acute otitis media were treated with penicillin-V alone or penicillin-V followed by Spiramycin or Trimethoprim-sulfamethoxazole (sequence therapy) in a double blind study. The combination penicillin-V + Trimethoprim-sulfamethoxazole eradicated the strains of Streptococcus pneumoniae and Branhamella catarrhalis. Nevertheless, the frequence of relapses and serous otitis media was not influenced and the investigation does not indicate that sequence therapy is an alternative in favour of penicillin-V treatment alone in primary cases of acute otitis media. In cases of repeated relapses caused by streptococcus pneumoniae, Trimethoprim-sulfamethoxazole may be a useful alternative.