Korean J Otorhinolaryngol-Head Neck Surg.  2024 Mar;67(3):138-145. 10.3342/kjorl-hns.2023.00311.

A Study on Antibiotics Selection for Patients With Chronic Otitis Media With Postoperative Infection

• Park KW
• Lee DE
• Kim HC
• Cho HH

• KMID: 2553733
• DOI: http://doi.org/10.3342/kjorl-hns.2023.00311

Abstract

Background and Objectives
Few studies have been reported on the strains that cause postoperative infection after chronic otitis media (COM) surgery. This study examined the direction of empirical antibiotics selection for patients with postoperative infection.
Subjects and Method
This was a retrospective study of 33 patients who were admitted for antibiotics therapy after suffering intractable post-operative infection of COM surgery at Chonnam National University Hospital from 2011 to 2021. Demographic data and microbial culture results of pre-operation and post-operative infection, as well as selected antibiotics for different time periods were evaluated.
Results
Most common pathologic organisms responsible for post-operative infection were Methicillin-resistant Staphylococcus aureus (MRSA) (45.5%) and Ciprofloxacin-resistant Pseudomonas aeruginosa (CRPA) (12.1%). Interestingly, there were only three cases where pre- and post-operative culture tests were the same, testing positive for two MRSA and one CRPA. The antibiotics selected as empirical antibiotics for postoperative infection were ceftazidime (48.5%) and vancomycin (27.3%). The rate of the cases where the selected empirical antibiotic was sensitive to the strain was 63.6%, and the rate of changing the antibiotics according to the microbial culture test result was 39.4%.
Conclusion
The strains cultured from the otorrhea of post-operatively infected patients had a very high ratio of drug-resistant strains and were different from the strains cultured from the otorrhea before surgery. Therefore, a microbial culture test is essential when an infection occurs after surgery, and regardless of the preoperative culture test results, patients with intractable postoperative infections should be treated with empirical vancomycin.

Keyword

Anti-bacterial agents; Culture; Otitis media; Postoperative complications; Surgical wound infection