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Scholars Journal of Applied Medical Sciences | Volume-2 | Issue-06
Efficacy of Topical Antibiotics Alone in the Treatment of Chronic Suppurative Otitis Media (CSOM)
Maya B. Kharche, Sharad Mehta, Sandeep Tripathi
Published: Nov. 28, 2014 | 119 92
DOI: 10.36347/sjams.2014.v02i06.020
Pages: 2046-2052
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Abstract
This study was undertaken to find out the microbiological profile of patients suffering from chronic suppurative otitis media (CSOM) with reference to Pseudomonas and its various species and to evaluate the efficacy of topical antibiotics alone in the treatment of chronic suppurative otitis media. This prospective outcome study was carried out at secondary care hospital on patients attending ENT and Microbiology Department from the year March 2010 to March 2013. All the patients attending the ENT dept with chronic ear discharge of more than 1 month were examined. Swabs were taken from each affected ear. Once the culture and sensitivity report was available patients were given topical antibiotics (Quinolone and Gentamycin ear drops) and their clinical responses were observed at weekly interval for one month. A repeat swab was taken after one month of treatment to know the bacteriological elimination. Of the total 600ear swabs, 793 organisms were isolated. Pseudomonas aeruginosa was the commonest organism grown in both paediatric and adult patients in chronic suppurative otitis media (Tubo tympanic type) where as MSSA was most common gram positive organism isolated. The sensitivity of Pseudomonas was highest to Polymyxin (90.3 %) followed by Ciprofloxacin (80.7%) and Cefepime (75.5 %) where as MSSA found to be sensitive to Clindamycin (100%), Cefazoline (92.5%) and Ciprofloxacin ( 67.1%) in that order. Out of 571 patients of csom, who have completed follow up, 478 had dry ears. 21 patients had persistent mucoid discharge inspite of organism being susceptible to used antibiotic. In conclusion, Pseudomonas aeruginosa is the commonest organism in chronic suppurative otitis media without cholesteatoma even in paediatric patients. Topical ciprofloxacin ear drop is most effective in clearing the infection and making the ear dry. There is no need for systemic antibiotic in uncomplicated chronic suppurative otitis media.