Acute otitis media (OSA) is one of the most common diseases in children and adults and the most common cause of antibiotic therapy, often unreasonable. 20–70% of respiratory infections in adults and children is complicated by the development of CCA. Despite the fact that only 10% of CCA has a viral etiology, the vast majority of CCA are also viral-bacterial co-infection. The article presents the main pathogenetic mechanisms of the development of CCA, such as viral and virus-induced. The term “heat-generating” microorganisms is introduced. A review of the most common pathogens of CCA viral and bacterial. An otomicroscopic picture is described based on the generally accepted domestic classification of CCA. The main tympanometric curves and their types during CCA are presented. Much attention is paid to the modern principles of pathogenetic and symptomatic therapy. In particular, local anti-inflammatory and analgesic therapy using ear drops containing lidocaine. Some progress in the prevention of acute otitis media is discussed, which has led to a decrease in the frequency of visits to doctors about otitis media and the appointment of antibiotics. This is due to the widespread use of vaccines, as well as the introduction of “wait-and-see” tactics in mild and moderate cases of CCA without initial antibiotic treatment. Success in reducing the incidence of CCA will depend mainly on preventing the colonization of the nasopharynx by otopathogens, as well as reducing the incidence of viral infections. According to international and domestic recommendations, the basis for the prevention of acute otitis media is vaccination against pneumococcus, hemophilus bacillus and influenza virus. © 2020, Remedium Group Ltd. All rights reserved.