Understanding antibiotic resistance patterns in chronic suppurative otitis media (CSOM) at a Tertiary Care Hospital

Background: Chronic Suppurative Otitis Media (CSOM) is a persistent middle ear inflammation with ear discharge, hearing loss, and tympanic membrane perforation. Management relies on antibiotics, but rising resistance limits treatment options, emphasizing the need for targeted antimicrobial strategies. This study assessed antibiotic resistance in CSOM at a tertiary hospital, with a focus on treatment efficacy and linezolid’s role against Staphylococcus aureus. Methods: This retrospective study was conducted at SUM ULTIMATE Hospital, Bhubaneswar, from September 2022 to August 2023, total of 700 bacterial samples grown from CSOM were experimented. Patients diagnosed with CSOM were identified through medical records. Clinical and demographic data, including age, gender, duration of symptoms, previous antibiotic use, and comorbidities, were collected. Ear discharge samples were cultured for bacterial identification, and antibiotic sensitivity testing was performed using the Kirby-Bauer disc diffusion method. Results: S. aureus (40%) and Pseudomonas aeruginosa (30%) were the most commonly isolated pathogens. S. aureus exhibited resistance to penicillin (70%), cephalosporins (65%), and macrolides (50%). P. aeruginosa showed 90% resistant to beta-lactams, 85% to fluoroquinolones, and 70% to aminoglycosides. Notably, linezolid was effective against all tested S. aureus bacterial isolates, showing no resistance. Patients with prior antibiotic exposure had significantly higher resistance rates (80%) compared to those without prior exposure (50%). Conclusion: The increasing prevalence of antibiotic-resistant pathogens, particularly S. aureus and P. aeruginosa, in CSOM presents a significant challenge for clinical management. However, linezolid demonstrated complete sensitivity against all S. aureus, highlighting its potential as a valuable treatment option, against resistant pathogens.