Microbiology of chronic suppurative otitis media in children

The aerobic microorganisms present in 51 middle ears of 36 children with chronic suppurative otitis media without cholesteatoma were evaluated. Specimens were taken directly from the middle ear through a patent perforation or tympanostomy tube and cultured using standard techniques. Twenty-three microbiologic species were identified, with Pseudomonas aeruginosa being the most prevalent (67% of ears) and the only organism in 31% of ears. The initial treatment of all patients was intravenous administration of an antimicrobial selected on the basis of culture and susceptibility reports; this treatment was successful in all but four children, who subsequently required tympanomastoid surgery. These results indicate that medical therapy, based on the results of culture and susceptibility studies, provides a viable alternative to major mastoid surgery in the management of chronic suppurative otitis media without cholesteatoma.