Study to Identify and Characterize the Bacteria Causing Acute Otitis Media Episodes in Young Children in Saudi Arabia

Inclusion Criteria: A child will be eligible for inclusion if he/she meets the following criteria: * Age: ≥ 3 months and \< 5 years at the time of enrolment. The subject becomes ineligible on the fifth birthday. * Signs, symptoms, and conditions: i. One of the functional or general signs of otalgia (or its equivalent: irritability), conjunctivitis, fever AND EITHER ii. Paradise's criteria (bulging, diffused or localised inflamed tympanic membranes) OR iii. Spontaneous otorrhoea of less than 24 hours * Onset of signs and symptoms of AOM within 72 hours prior to diagnosis of AOM by a physician. To be included as treatment failure, subjects must have then received antibiotic treatment from the physician, but remain symptomatic 48-72h after initiation of treatment * Written informed consent obtained from parent or guardian prior to study start. Exclusion Criteria: The following criteria should be checked at the time of study entry. If any apply, the child must not be included in the study. * Hospitalised during the diagnosis of AOM or during treatment, * Otitis externa, or otitis media with effusion * Presence of a transtympanic aerator * Systemic antibiotic treatment received for a disease other than AOM in the 72 hours prior to enrolment, * Receiving antimicrobial prophylaxis for recurrent AOM, * Provision of antibiotic by paediatrician/ENT specialist at the enrolment visit, prior to the sampling * Patients on antibiotics for AOM who are clinically improving.