Abstract

OTITIS MEDIA: A CLINICAL ASSESSMENT OF ETIOLOGICAL PATHOGENS, SUSCEPTIBILITY STATUS AND AVAILABLE THERAPEUTIC OPTIONS AMONG 19 ANTIBACTERIAL AGENTS IN MAIDUGURI-CITY, NIGERIA

*John David, OHIEKU and Funsho Emmanuel, FAKUADE

ABSTRACT

Patients with Otitis Media were assessed for etiological pathogens and their susceptibility status to evaluate available anti-bacterial treatment options. 125 patients (69 males and 56 females) were studied with 107 (85.6%) showing laboratory evidence of the disease. Children below 2 years had the highest cases (45.8%) while others include: preschool age (18.7%), school age group (8.4%), teenage group (3.7%), adults (22.5%) and the geriatrics (0.94%). Otitis Media conditions were higher in the male (55.2%) than the female subjects (44.8%). The isolated pathogens were Pseudomonas spp (42.7%), Staphylococcus aureus (21.4%), Klebsiella spp (13.7%), Proteus spp (11.9%), Escherichia coli (8.6%) and Streptococcus spp (1.7%). Pseudomonas spp sensitivities were ciprofloxacin (92%), pefloxacin (81.4%), ofloxacin (86.4%), streptomycin (81.3%), ceftriaxone (100%) and azithromycin (100%) but recorded high resistance to co-trimoxazole (90.9%), ampicillin (90.5%) and amoxicillin/clavulanic acid (75.6%). Staph aureus showed sensitivities to rifampicin (90.9%), levofloxacin (100%), cefuroxime (100%) and gentamicin (83.3%) with ampicillin/cloxacillin recording the least (15.8%). Klebsiella spp showed the highest susceptibility to ofloxacin (92.9%) and streptomycin (80%) but activities of cotrimoxazole (30.8%), ampicillin (15.4%) and nalidixic acid (7.7%) were recorded against Proteus spp in contrast to the 100%, 91.7% and 75% activities recorded by ceftrioxone, pefloxacin and streptomycin respectively. E. coli showed 100% sensitivity to ofloxacin but indicated high resistances to ampicillin (70%), co-trimoxazole (80%) and amoxicillin/clavulanic acid (80). Several agents have promising ex-vivo activities against many pathogens but there are few treatment options because of the limited applications of the fluoroquinolones in children, the potential ototoxicity of the aminoglycosides, the high resistance rates of many agents and the high costs/parenteral dosage forms of others.

Keywords: Fluoroquinolones, Pseudomonas, Otitis media, pathogens, Resistance, Maiduguri-city.