Publication:

Bacteriological profile and antibiotic resistance in cases of chronic otitis media and its clinical implications

Background Chronic otitis media (COM) is the commonest otologic conditions worldwide with great risk of irreversible complications. Early bacteriological diagnosis is essential for appropriate effective therapy to reduce the disease burden. However in our clinical practice, it was noticed that the morbidity of the disease was mostly non responsive to standard antibiotic medical care. The poor response to routine treatment gave rise to suspicion of antibiotic resistance. This prompted us to undertake this study with the objective to isolate and identify the causative organisms in COM in our clientele and study their antimicrobial susceptibility pattern for a better analysis and institution of accurate therapy.

Methods A prospective cross sectional analysis was performed using culture and antibiotic susceptibility test results of 500 patients who visited the ENT OPD at a tertiary care centre between July 2016 to June 2017.

Results A positive culture was obtained in 466/500 (93.2%) of the samples. No growth was seen in 34 patients (6.8%). 454 samples showed single bacterium while 12 samples had mixed growth. Pseudomonas aeruginosa was the predominant organism (54%) followed by Staphylococcus aureus. On antibiotic sensitivity, high resistance patterns to most common first line antibiotics used in COM was observed.

Conclusions Irrational use of antibiotics for management of COM has led to the emergence of multidrug-resistant bacterial strains. Evaluation of micro bacterial growth and their antibiotic sensitivity pattern in local area helps in prescribing empirical antibiotics for successful treatment of COM.