Preoperative treatment of children with chronic suppurative otitis media

259 patients with chronic suppurative otitis media were bacteriologically assessed. 12 bacterial strains were isolated in 196 of the cases. The most common species present was Staphylococcus - 77 (39%) cases, followed by Proteus vulgaris isolated in 36 (18%) cases, and Pseudomonas aeruginosa in 33 (17%) cases. The flora in 25 cases (18%) yielded two bacterial strains with identical oxygen demands, and a mixture of Staphylococcus and Streptococcus in 32%. In 60.6% of cases the flora was sensitive to ototoxic antibiotics (gentamycin, kanamycin and neomycin), especially to gentamycin - 29.9%. The highest sensitivity of the flora to non-ototoxic antibiotics was to chlorocid (in 25.5% of the cases). Topical and systemic treatment were administered based on antibiogram and the inflammation and the otorrhea were controlled in 91.4% of the cases. No or little effect was found in the patients with cholesteatoma (8.6%). A conclusion was made that the monoflora was the commonest in the ear effusion (87%), comprising facultative anaerobes, present in 63.8%, anaerobes in 18.8%, and aerobes, mainly Pseudomonas aeruginosa, in 17.4%. The combined (topical and systemic) treatment based on antibiogram is effective in the preoperative management of the inflammation.