Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort

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dc.contributor.authorMeyer, E
dc.contributor.authorWhitelaw, A
dc.contributor.authorEdkins, O
dc.contributor.authorFagan, J J
dc.date.accessioned2021-10-08T07:18:03Z
dc.date.available2021-10-08T07:18:03Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Chronic otorrhoea is difficult to treat, with treatment in South Africa (SA) being protocol driven and generally initiated at the primary healthcare level. There is a lack of local studies that focus on the bacteriology and antimicrobial sensitivities of chronic otorrhoea, which underpins the management advice offered. AIMS: To determine the microbiological profile and antimicrobial susceptibility of patients with chronic otorrhoea and the validity of the Department of Health's (DoH) current guideline. METHODS: We conducted a prospective study at Groote Schuur Hospital from 2005 to 2009. We included patients with chronic otorrhoea classified as either otitis media or otitis externa, according to our definitions. Pus swabs were taken, from which microorganisms were cultured and tested for antimicrobial susceptibility. RESULTS: Of 79 patients with otorrhoea, 50 had otitis media, 21 had otitis externa and the condition was not determined in 8 patients. The most common organism isolated with otitis media was Proteus mirabilis (18/50; 36%) and with otitis externa, Pseudomonas aeruginosa (7/21; 33%). Otorrhoea had a different microbial spectrum compared with international reports, with methicillin-resistant Staphylococcus aureus infection in a single patient. The organisms isolated were susceptible mainly to fluoroquinolones (96%) and aminoglycosides (81%). CONCLUSION: Amoxicillin is a poor choice of antibiotic due to its low sensitivity, which calls into question the current DoH guideline for otorrhoea. Antimicrobial treatment protocols should be based on local data and be revisited from time to time. This study suggests that, should first-line treatment fail, an antibiotic with Gram-negative cover, e.g. a topical fluoroquinolone, should be considered.
dc.identifier.apacitationMeyer, E., Whitelaw, A., Edkins, O., & Fagan, J. J. (2013). Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort. <i>South African Medical Journal</i>, 103(7), 471 - 177. http://hdl.handle.net/11427/34893en_ZA
dc.identifier.chicagocitationMeyer, E, A Whitelaw, O Edkins, and J J Fagan "Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort." <i>South African Medical Journal</i> 103, 7. (2013): 471 - 177. http://hdl.handle.net/11427/34893en_ZA
dc.identifier.citationMeyer, E., Whitelaw, A., Edkins, O. & Fagan, J.J. 2013. Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort. <i>South African Medical Journal.</i> 103(7):471 - 177. http://hdl.handle.net/11427/34893en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Meyer, E AU - Whitelaw, A AU - Edkins, O AU - Fagan, J J AB - BACKGROUND: Chronic otorrhoea is difficult to treat, with treatment in South Africa (SA) being protocol driven and generally initiated at the primary healthcare level. There is a lack of local studies that focus on the bacteriology and antimicrobial sensitivities of chronic otorrhoea, which underpins the management advice offered. AIMS: To determine the microbiological profile and antimicrobial susceptibility of patients with chronic otorrhoea and the validity of the Department of Health's (DoH) current guideline. METHODS: We conducted a prospective study at Groote Schuur Hospital from 2005 to 2009. We included patients with chronic otorrhoea classified as either otitis media or otitis externa, according to our definitions. Pus swabs were taken, from which microorganisms were cultured and tested for antimicrobial susceptibility. RESULTS: Of 79 patients with otorrhoea, 50 had otitis media, 21 had otitis externa and the condition was not determined in 8 patients. The most common organism isolated with otitis media was Proteus mirabilis (18/50; 36%) and with otitis externa, Pseudomonas aeruginosa (7/21; 33%). Otorrhoea had a different microbial spectrum compared with international reports, with methicillin-resistant Staphylococcus aureus infection in a single patient. The organisms isolated were susceptible mainly to fluoroquinolones (96%) and aminoglycosides (81%). CONCLUSION: Amoxicillin is a poor choice of antibiotic due to its low sensitivity, which calls into question the current DoH guideline for otorrhoea. Antimicrobial treatment protocols should be based on local data and be revisited from time to time. This study suggests that, should first-line treatment fail, an antibiotic with Gram-negative cover, e.g. a topical fluoroquinolone, should be considered. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 7 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2013 SM - 0038-2469 T1 - Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort TI - Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort UR - http://hdl.handle.net/11427/34893 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34893
dc.identifier.vancouvercitationMeyer E, Whitelaw A, Edkins O, Fagan JJ. Chronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort. South African Medical Journal. 2013;103(7):471 - 177. http://hdl.handle.net/11427/34893.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Medical Microbiology
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue7
dc.source.journalvolume103
dc.source.pagination471 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.6066
dc.subject.otherOtitis Media
dc.subject.otherOtitis Externa
dc.subject.otherInfection
dc.subject.otherFluoroquinolones
dc.subject.otherAminoglycosides
dc.subject.otherAmoxicillin
dc.subject.otherMethicillin Resistance
dc.subject.otherClinical Protocols
dc.subject.otherTherapeutics
dc.subject.otherProspective Studies
dc.subject.otherSensitivity and Specificity
dc.subject.otherPseudomonas aeruginosa
dc.subject.otherStaphylococcus aureus
dc.subject.otherProteus mirabilis
dc.subject.otherHomo sapiens
dc.subject.otherENT
dc.subject.otherotorrhea
dc.subject.othermicrobiology
dc.titleChronic otorrhoea: Spectrum of microorganisms and antibiotic sensitivity in a South African cohort
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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