Otitis media, which is an inflammatory process in the middle ear cavity, is a fairly common disease. Its incidence is up to 30 % of all otolaryngological pathology. The main route of transmission is tubogenic, in which the pathogen migrates from the nasopharynx into the middle ear cavity through the pharyngeal pouch of the auditory tube. The main causative agents of acute otitis media are S. pneumoniae and nontypeable strains of H. influenzae, less often — M. catarrhalis. Otitis media of viral etiology occurs in no more than 6 % of cases. Most often, otitis media affects children, mostly under the age of 3 years. The course of the disease is characterized by a pronounced staging of the pathological process: the catarrhal stage is replaced by the purulent one, which turns into the reparative one during recovery. In adult patients, inflammation of the middle ear is relatively rare; the older age group is characterized by an atypical course without otorrhea and pain in the mastoid process. The main complications of otitis media include the spread of infection into the intracranial space, the occurrence of the facial nerve paresis, and the development of mastoiditis and sepsis. One of the main problems in the treatment of otitis media is the resistance of the microflora that caused it to β-lactam drugs.