Antibiotics are the first line of defense against ear infections. Different germs are killed by different antibiotics, some being more difficult to kill than others. Since we cannot easily take cultures of the infection behind the eardrum, it may be necessary to use more that one antibiotic before finally obtaining an uninfected ear. Occasionally no antibiotic seems to work. When this happens it becomes necessary to puncture the eardrum to let the infection out before a complication occurs. Myringotomy tubes may be placed in the puncture site to keep the eardrum from healing before the infection has adequately cleared.