In 60 patients suffering from acute ear, nose and throat infections the efficacy and safety of cefotiam hexetil (SCE-2174, CAS 61622-34-2) which is a pro-drug of cefotiam was studied. The clinical success rate (improvement/cure) achieved with a daily administration of 600 mg was 90%. In 63% of the cases being evaluable for bacteriological response an eradication of the causative pathogens at the end of the treatment period was found. The majority of the patients tolerated well the compound. Side effects which were possibly, likely or definitely related to the treatment were observed in 12 patients. In 7 of these patients the treatment had to be stopped due to side effects which is equivalent to an intolerance rate of 12%. The data obtained in the present study indicate that cefotiam hexetil is a potent drug for the treatment of acute and acute on top of chronic infections of the upper aerodigestive tract.