Chronic otitis media is a frequent and serious bacterial infection. Ear infections are common in poor countries and one of the most common reasons for health consultations and prescriptions for antibiotics. Very few studies of chronic otitis media were performed in Malagasy people. The aim of the present study was to identify the bacteria responsible for chronic otitis media in order to assess the susceptibility of bacteria to antibiotics.
This is a prospective, multicentric, descriptive and analytical study of unilateral atrial flow from patients with chronic otitis media seen in external consultation in 3 sanitary formations in Antananarivo. The bacteriological examinations of the samples were carried out within the Microbiology Unit of the Laboratory of Training and Research in Medical Biology Faravohitra Antananarivo. The study was carried out over a period of 3 months running from November 2016 to January 2017.
Two hundred patients are under chronic otitis media, and 41.5% of the patients had already received antibiotic treatment before sampling. Bacteriological examination was negative in 31.3% (n = 26) of the case when antibiotic therapy was started before taking the sample (p = 0.0001). Germs were found in 73.5% of the samples. Staphylococcus aureus (28.6%) and Coagulase-negative Staphylococci (26.5%) were the main germs responsible for chronic otitis media followed by Proteus mirabilis (15.6%) and Pseudomonas aeruginosa (10.9%).
The imipenem had good activity on enterobacterial strains. However, its low tissue diffusion, the absence of oral and local presentation, the very high cost limit the use of this molecule to treat chronic otitis media. Regardless of the bacteria involved in chronic otitis media, gentamicin and ciprofloxacin have shown a high sensitivity. The ototoxicity of gentamicin should prompt us to take our therapeutic choice on another antibiotic such as ciprofloxacin. Quinolones do not carry a potential side effect of cochleotoxicity and vestibulotoxicity, which are attributed to aminoglycosides.