Pathogenic agents of chronic suppurative otitis media in Ilorin, Nigeria.

OBJECTIVE: To determine the type and pattern of antibiotic susceptibility of the pathogenic micro-organisms causing chronic suppurative otitis media (CSOM) in our environment.
DESIGN: A retrospective study of ear discharges from patients presenting consecutively with chronic suppurative otitis media. SETTINGS: University of Ilorin Teaching Hospital, a major referral centre in the Middle Belt region of Nigeria. MAIN OUTCOME MEASURES: Bacterial isolates and their sensitivity patterns.
SUBJECTS: Three hundred and seventy five patients aged between eight months and 70 years referred to the ear, nose, and throat clinic of The University of Ilorin Teaching Hospital were enrolled in the study.
RESULTS: About 95.5% and 4.5% of the specimens were culture positive and negative respectively. The commonest bacterial aetiologic agents were Pseudomonas aeruginosa (26.0%) and Proteus spp (21.8%). Peak prevalence of 30.5% occurred among the 0-5 years age group. Seventy five per cent of isolates were gram-negative bacteria. Ofloxacin produced 100% sensitivity in both gram positive and gram-negative organisms tested. Colistin, ceftazidime and cefuroxime were highly active (80%) against the gram-negative bacteria while erythromycin and cloxacillin were very effective (80%) against the gram-positive isolates.
CONCLUSION: Chronic suppurative otitis media is still highly prevalent in our environment, affecting mainly children. The antibiotic susceptibility pattern of pathogenic isolates is different from those of other regions of Nigeria with increasing resistance recorded for some organisms. Hence, where possible and available, susceptibility tests should guide the management of CSOM in this environment, otherwise, ofloxacin if indicated and cloxacillin/erythromycin may provide relief and delay emergence of resistant strains.