BACKGROUND Chronic suppurative otitis media (CSOM) is a disease of multiple aetiology and its importance lies in its chronicity and dreaded complications. Both Gram-positive and negative organisms are responsible for infection of the middle ear. Due to advent of newer and sophisticated antibiotics, the microbiological flora is changing constantly. This requires a reappraisal of the flora in CSOM and their in vitro antibiotic sensitivity pattern in cases of CSOM, which do not respond to local antibiotics. The frequent presence of CSOM in general practice and its poor response to the routine treatment are the factors responsible for undertaking this study. MATERIALS AND METHODSOne hundred and fifty patients with tubotympanic type of CSOM were prospectively studied. They had chronic ear discharge and had not received antibiotics for the previous five days. Swabs were taken and cultured for bacteria. The standard method of isolation and identification was followed. Antimicrobial susceptibility of the bacterial isolates was performed by Kirby-Bauer's disc diffusion method. RESULTSAnalysis of bacterial flora of the present study showed predominance of Gram-negative bacilli (41.4%). The highest incidence (36.5%) was that of Pseudomonas aeruginosa followed by Staphylococcus aureus (29.5%). Overall most sensitive antibiotic groups were Fluoroquinolones and Cephalosporins and least effective were Penicillin and Macrolides. CONCLUSIONThe outcome of our study enabled us to set an empirical medical treatment for an early resolution of ear discharge and inflammation in our patients with CSOM as we could understand the aetiological pathogens and their susceptibility pattern. Effective medical treatment in obtaining a discharge free ear prior to surgical treatment led us to improve the surgical outcome in our patients with CSOM.

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Abstract2H-1-benzopyran-2-one (Coumarin), an important oxygen heterocyclic scaffold, widely distributed throughout the plant kingdom, displayed a wide range of potential biological activities such as anti-microbial, anti-inflammatory and antioxidant activities. In this paper, we have synthesized a novel class of 3,7-disubstituted 2H-1-benzopyran-2-one derivatives (3aa-3hb) bearing a basic ether side chain at C-7 and a substituted phenyl ring at C-3 of the coumarin ring. These compounds have been evaluated for anti-microbial (antibacterial/antifungal) activities. Some of the compounds 3ac, 3ae, 3bb, 3bc have shown significant anti-fungal activities against selective strains. Compound 3ae and 3bc with the MIC values of 1.56 µg/mL displayed better antifungal activity than fluconazole against Trichophyton mentagrophytes.

BACKGROUNDAmong the bacteria causing CSOM, Pseudomonas aeruginosa has been particularly blamed for the deep-seated and progressive destruction of middle ear and mastoid structures through its toxins and enzymes. Objective-To study the prevalence and antimicrobial sensitivity pattern of P. aeruginosa in CSOM cases. MATERIALS AND METHODSThis study was conducted over a time period of one and a half years. Pseudomonas aeruginosa isolates from ear discharge specimens of clinically diagnosed cases of CSOM were identified and confirmed by standard methods. Antimicrobial sensitivity testing of the isolates was done by Kirby-Bauer disc diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTSAll the 42 (100%) isolates were sensitive to fluoroquinolone group of antibiotics whereas cephalosporin was the second most effective group, which showed 97% sensitivity. It was followed by Aminoglycosides (60%), Ampicillin (23%), Macrolides (22%) and Amoxicillin/clavulanic acid (15%). CONCLUSIONOverall the most sensitive antibiotic groups were fluoroquinolones and cephalosporins and least effective were penicillins and macrolides. Antimicrobial stewardship should be practised to prevent MDR cases. The infection control measure should be followed properly.