Prescribing Pattern Versus Antibiotic Sensitivity and Outcome of Antibiotic Usage in Patients with Chronic Suppurative Otitis Media at Teritary Care Hospital

BACKGROUND: Chronic Suppurative Otitis Media (CSOM) is a prevalent, persistent infection of the middle ear, particularly in developing countries. It is associated with microbial colonization and inappropriate antibiotic use, contributing to rising resistance patterns. OBJECTIVES: This study aimed to evaluate the prescribing patterns and clinical outcomes of antibiotic therapy in CSOM patients, identify the causative microorganisms, determine antibiotic sensitivity and resistance patterns, compare empirical versus culture-guided therapy, and assess the role of clinical pharmacists in prescription optimization. METHODS:A prospective observational study was conducted over six months (Nov 2023–Apr 2024) at a tertiary care hospital in rural South India. Sixty clinically diagnosed CSOM patients were enrolled based on inclusion/exclusion criteria. Ear swabs were subjected to microbiological culture and antibiotic susceptibility testing. Data on empirical antibiotic therapy, revised treatment based on culture reports, and patient outcomes were recorded and analysed. RESULTS: Of 60 CSOM patients, 52% were male, with peak incidence in the 21–40 age group. Rightsided CSOM was most common (46.7%). MRSA (40%) and P. aeruginosa (35%) were the predominant isolates. Gram-negative organisms accounted for 60%, and Gram-positive for 40%. High sensitivity was noted for gentamicin and amikacin, while amoxicillin/clavulanic acid and ceftazidime showed high resistance. Culture-guided therapy showed significantly better clinical improvement. CONCLUSION: The study underscores the critical need for routine culture and sensitivity testing in CSOM management. Empirical antibiotic use without microbiological confirmation contributes to poor outcomes and resistance. Empirical therapy was inappropriate in 40% of cases, prompting pharmacist-guided modifications that led to improved outcomes. Clinical pharmacists play a pivotal role in monitoring prescription patterns and guiding rational antimicrobial therapy. These findings support the development of local antibiotic policies to guide effective treatment