Role of anaerobes in chronic otitis media.

A mixed bacterial flora of aerobic and anaerobic organisms can be isolated from the mucopurulent discharge in nearly 50% of individuals with active chronic otitis media. The role of the anaerobic flora has never been defined. A total of 33 patients with a mixed bacterial flora were treated with metronidazole alone or in combination with systemic antibiotics. The anaerobic flora was eliminated in 15 of 23 compliant individuals but the ears remained clinically active or mucoid in all. Anaerobic organisms would appear unlikely to be the primary pathogen in active chronic otitis media. Metronidazole alone or in combination with systemic antibiotics would also appear to be an ineffective medical treatment of active chronic otitis media as none of the 23 ears became inactive.