The bacteriology of chronic suppurative otitis media.

Specimens obtained directly from the middle ear under direct vision from 40 patients with chronic suppurative otitis media (CSOM) were investigated quantitatively and qualitatively for aerobes and anaerobes. Twenty one of the 40 specimens yielded aerobes only, 17 yielded a mixed flora of anaerobes and aerobes while only one yielded anaerobes only and the remaining one was sterile. Bacteroides fragilis was the commonest anaerobe and the second single most common bacteria generally present in CSOM. Pseudomonas aeruginosa and Staphylococcus aureus were the dominant aerobic flora appearing in 17 and 14 out of 40 specimens respectively. All pathogens isolated were present in very high counts averaging 10(8) ml of the exudate. The use of systemic anti-anaerobic drug combined with an anti-aerobic drug is worthy of a clinical trial.