Conservative medical management of chronic suppurative otitis media (CSOM) is an important step in achieving a dry ear. Topical antibiotic ear drops and aural toilet form the mainstay of medical management of noncholesteatomatous CSOM. This study analyzes the causal organisms and their sensitivity to various antibiotics. Out of 382 swabs examined, the major organisms isolated were Pseudomonas aeruginosa (27.2%), followed by Staphylococcus aureus (23.6%). The sensitivity of P aeruginosa was 100% to ceftazidime, 98.9% to ciprofloxacin, 96.3% to gentamicin, and 95.4% to polymyxin B, whereas the sensitivity of S aureus was 98.6% to ciprofloxacin, 97.4% to cloxacillin sodium, 96.5% to cotrimoxazole, and 90.7% to gentamicin. Pseudomonas aeruginosa was almost completely resistant to ampicillin (97.6%) and chloramphenicol (96.6%), whereas S aureus was almost completely resistant to ampicillin (73.8%) and polymyxin B (98.3%). Among the available topical antibiotic preparations for use in the ear, we found that ciprofloxacin and gentamicin are the best choices.
FinegoldSMBaronEJ. Infections of the head and neck. In: CarsonDC, ed. Bailey and Scott's diagnostic microbiology. 7th ed. St Louis, Mo: CV Mosby, 1986: 329–37.
2.
BauerAWKirbyWMMSherrisJCTurckM. Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol1966; 45: 493–6.
SenturiaBHBluestoneCDKleinJOLimDJParadiseJL. Report of the Ad Hoc Committee on Definition and Classification of Otitis Media and Otitis Media With Effusion. Ann Otol Rhinol Laryngol [Suppl]1980; 89(Suppl 68): 3–4.
5.
GoycooleaMVHuebMMRuahC. Otitis media: the pathogenesis approach. Definitions and terminology. Otolaryngol Clin North Am1991; 24: 757–61.
6.
PapastavrosTGiamarellouHVarledjidesS. Obtaining specimens of discharge from the middle ear for cultures. Laryngoscope1985; 95: 1413–4.
7.
BrookI. Management of chronic suppurative otitis media: superiority of therapy effective against anaerobic bacteria. Pediatr Infect Dis J1994; 12: 355–6.
8.
ErkanMAslanTSevükEGüneyE. Bacteriology of chronic suppurative otitis media. Ann Otol Rhinol Laryngol1994; 103: 771–4.
9.
BrookISantosaG. Microbiology of chronic suppurative otitis media in children in Surabaya, Indonesia. Int J Pediatr Otorhinolaryngol1995; 31: 23–8.
10.
IndudharanRHaqJA. Use of pre-reduced swabs in bacteriology of chronic suppurative otitis media. J Laryngol Otol1996; 110: 950–1.
11.
BrookI. Chronic otitis media in children: microbiological studies. Am J Dis Child1980; 134: 564–6.
12.
BrookI. Aerobic and anaerobic bacteriology of cholesteatoma. Laryngoscope1981; 91: 250–3.
13.
IkedaKTakasakaT. In vitro activity of ototopical drops against middle ear pathogens. Am J Otol1993; 14: 170–1.
14.
DoharJEKennaMAWadowskyRM. In vitro susceptibility of aural isolates of Pseudomonas aeruginosa to commonly used ototopical antibiotics. Am J Otol1996; 17: 207–9.
15.
DoharJEKennaMAWadowskyRM. Therapeutic implications in the treatment of aural Pseudomonas infections based on in vitro susceptibility patterns. Arch Otolaryngol Head Neck Surg1995; 121: 1022–5.
16.
The Director General of Health, ed. List of drugs. Antiinfectives. 3rd ed. Kuala Lumpur, Malaysia: Ministry of Health, 1994: 124.
17.
IndudharanRHaqJAMohamadHMohamadZ. Role of topical antibiotics versus antibiotic-steroid combination in the management of chronic suppurative otitis media. In: McCaffertyGComanWCarrollR, eds. XVI World Congress of Otorhinolaryngology, Head & Neck Surgery. Sydney 1997. Vol 1. Bologna, Italy: Monduzzi Editore SpA, 1997: 1153–7.
18.
BrowningGGGatehouseSCalderIT. Medical management of active chronic otitis media: a controlled study. J Laryngol Otol1988; 102: 491–5.
19.
MerifieldDOParkerNJNicholsonNC. Therapeutic management of chronic suppurative otitis media with otic drops. Otolaryngol Head Neck Surg1993; 109: 77–82.
20.
WongDLRutkaJA. Do aminoglycoside otic preparations cause ototoxicity in the presence of tympanic membrane perforations?. Otolaryngol Head Neck Surg1997; 116: 404–10.
21.
ChambersHFSandeMA. Antimicrobial agents: the aminoglycosides. In: HardmanJGGilmanAGLimbirdLE, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 9th ed. New York, NY: McGraw-Hill, 1996: 1103–21.
22.
EngelFBlatzRKellnerJPalmerMWellerUBhadkiS. Breakdown of the round window membrane permeability barrier evoked by streptolysin O: possible etiologic role in development of sensorineural hearing loss in acute otitis media. Infect Immun1995; 63: 1305–10.
23.
IkedaKSakagamiMMorizonoTJuhnSK. Permeability of the round window membrane to middle-sized molecules in purulent otitis media. Arch Otolaryngol Head Neck Surg1990; 116: 57–60.
24.
GoycooleaMVMuchowDCGoycooleaHG. Otitis media: 16 years of pathogenesis approach. Otolaryngol Clin North Am1991; 24: 967–80.
25.
JohanssonUHellströmSAnnikoM. Round window membrane in serous and purulent otitis media. Structural study in the rat. Ann Otol Rhinol Laryngol1993; 102: 227–35.
26.
RauchSDOasJG. Intratympanic gentamicin for treatment of intractable Meniere's disease: a preliminary report. Laryngoscope1997; 107: 49–55.
27.
DriscollCLKasperbauerJLFacerGWHarnerSGBeattyCW. Low-dose intratympanic gentamicin and the treatment of Meniere's disease: preliminary results. Laryngoscope1997; 107: 83–9.
