Treatment failure in pediatric acute otitis media: How do you define?

Enhancement of Trans-Tympanic Drug Delivery by Pharmacological Induction of Inflammation

“…Oral antibiotics can cause adverse effects such as diarrhea, vomiting, or skin rash, which can limit treatment. Failure of treatment in children can lead to recurrent OM and chronic OM, with increased risk of hearing loss and speech delay. , Moreover, these frequent administrations of antibiotics are believed to contribute to the emergence of antibiotic-resistant bacteria . A drug delivery system that could place drugs directly into the middle ear through the tympanic membrane (TM) would bypass the systemic circulation and would obviate all of these undesirable effects.…”