Introduction and objective: Acute otitis media is one of the most common inflammatory conditions in childhood. The aim of the study was to analyse the aetiology of acute suppurative otitis media in paediatric patients hospitalised between 2023 and 2024. Material and methods: Seven patients with acute suppurative otitis media with perforation who underwent ear canal swabbing for culture were retrospectively analysed. Results: The following pathogens were isolated: Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pyogenes and Staphylococcus epidermidis. Conclusions: Culture with antibiogram is crucial in cases with tympanic membrane perforation and purulent discharge for selecting a targeted and effective antibiotic therapy.