Chronic suppurative otitis media (CSOM) is one of the most common chronic infectious diseases worldwide, especially affecting children. The patients or the parents of the affected children are often worried about the cost of medical visits, prescription medicines, or inconsistently effective medication. The complications of CSOM have been greatly reduced because of the development of antibiotics; however, the irrational use of antibiotics has led to the emergence of organisms resistant to the commonly used drugs. Owing to the increase in antibiotic resistance, the development of new treatments that will efficiently eradicate infectious microorganisms has become imperative. Boric acid solutions are effective in the treatment of CSOM because of their acidic effect. Various databases, such as the PubMed, The Cochrane Library, and SciELO, were searched for references related to the efficacy of boric acid in the treatment of mucosal CSOM, as well as its ototoxicity. The search revealed that boric acid is relatively effective in treating CSOM, especially at a high concentration. Boric acid in distilled water was found safe in animal studies. However, the ototoxicity of boric acid concentrations higher than 4% needs further evaluation, considering the effectivity of boric acid at high concentrations.

Backgrounds: Tonsillitis is the most common disease in otorhinolaryngology both acute and chronic, especially in children. Recurrent tonsillitis is a chronic inflammatory process in the palatine tonsils. Several studies have shown differences in pathogenic flora on surface and tonsillar core. This also causes an increase failure of eradicating germs in acute tonsillitis. Therefore, it falls into chronic stage. Identifying the bacterial organism in acute tonsillitis will guide appropriate antibiotic therapy that can revolutionize the management of chronic tonsillitis.Objectives: To determine the bacteria pattern from surface and tonsillar core in patients with recurrent tonsillitis. Methods: The research is a descriptive with cross sectional study. The sample of the study was patients with recurrent tonsillitis who underwent tonsillectomy surgery at Adam Malik General Hospital Medan and several satellite hospitals in Medan that met the inclusion criterias. Results:This study was attended by 33 recurrent tonsillitis subjects with more male(66,7%) and most of them below 20 years (66.7%).The most type of aerobic bacteria from surface and tonsillar core swabs was Staphylococcus aureus. Antibiotics that are still sensitive to Staphylococcus aureus in tonsillar core swabs are Gentamycin, Tigecycline, Clindamycin, and Inezolid. Antibiotics that are still sensitive to Staphylococcus aureus on surface smears are Tigecycline, Vancomycin, and Erythromycin. The bacteria form surface did not present bacteria from tonsillar core. The most anaerobic bacteria found on both ofthe surface and tonsillar core were Bacteroides fragilis.Conclusions:The swab cultures taken from the tonsillar surface may not always reveal the real pathogen of the tonsils. In addition, the estimated probability of tonsillar bacteriology by surface swabs varies with the type of the pathogen.