Bacteriology of chronic otitis media in Dar es Salaam, Tanzania.

Abstract

OBJECTIVES: To determine the aetiology of chronic otitis media (COM) in Dar es Salaam and to find out the shelf life of boric acid in spirit ear drops (BAISED). DESIGN: Cross-sectional study. SETTING: Muhimbili Medical Centre and selected primary schools within Dar es Salaam. MAIN OUTCOME MEASURES: Bacterial isolates and their sensitivity patterns and shelf life of BAISED. SUBJECTS AND METHODS: One hundred and seventy six pus swab specimens obtained from 150 patients with COM for more than three months were submitted for culture and antimicrobial sensitivity testing in 1997. RESULTS: The isolates included Pseudomonas aeruginosa (51.7%), Staphylococcus aureus (17.2%), Proteus mirabilis (13.2%), Klebsiella spp. (8.0%), Escherichia coli (5.8%) and unidentified coliforms in 4.0%. All isolates were sensitive to gentamicin. Sensitivity of Pseudomonas aeruginosa and Proteus mirabilis to kanamycin was 98.5% and 100%, respectively. P. aeruginosa was sensitive to chloramphenicol, ampicillin and tetracycline by 58.1%, 10.1% and 8.3%, respectively. Three per cent BAISED inhibited the growth of all Pseudomonas aeruginosa even after it has been stored at room temperature for six weeks. CONCLUSION: Based on these results, the drug of choice for management of COM in Dar es Salaam is gentamicin. However, given its ototoxicity effects and the fact that BAISED is effective and affordable, the later should be the treatment of choice.