‎ Active chronic suppurative otitis media poses a management problem. Different types of ‎treatment strategy were tried for 136 patients, 36 patients received systemic antibiotics, 26 ‎patients received local antibiotics, 42 patients combined local and systemic, and the last ‎group (32 patients) received no antibiotics. The majority of patients had moderate size ‎tympanic membrane perforation (59%). Eighty-two patients had severe (active) symptoms ‎‎(60%). The commonest types of bacteria isolated were streptococcus pneumoniae and ‎staphylococcus aureus (29%, 21% respectively). It is found that, the best type of treatment ‎was the local antibiotic therapy (84% improvement), followed by combined antibiotic therapy ‎‎(local and systemic) which equal to 83% improvement. There was no benefit of using ‎systemic antibiotics without aural toilet (5% improvement). It is important to mention that the ‎use of antibiotic/ steroid ear drop gave good improvement result (95%), in comparison with ‎the use of antibiotic ear drop (50%). ‎