The most common bacterial pathogens in acute otitis media are S pneumoniae, nontypeable H influenzae, and M catarrhalis. These three organisms are responsible for more than 95% of all acute otitis media cases with a bacterial etiology. Older studies indicated that S pneumoniae was more common; however, with the introduction of pneumococcal vaccines, nontypeable H influenzae now appears to be the most prevalent pathogen.
Of these three organisms causing acute otitis media, S pneumoniae is the least likely to resolve spontaneously. Attention is therefore focused on S pneumoniae for selection of antimicrobial therapy.
For more on the etiology of otitis media, read here.
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Cite this: Russell W. Steele. Fast Five Quiz: Do You Know How Best to Approach Otitis Media? - Medscape - Mar 23, 2015.