ACUTE OTORRHEA - BACTERIOLOGY OF A COMMON COMPLICATION OF TYMPANOSTOMY TUBES

We prospectively followed 246 children with tympanostomy tubes and obs erved acute otorrhea through a functioning tube at least once in 50% o f subjects. Pathogens typical of acute otitis media (Streptococcus pne umoniae, Hemophilus influenzae, Moraxella catarrhalis, and Streptococc us pyogenes) were found in 42% of all episodes; Pseudomonas aeruginosa or Staphylococcus aureus was found in 44% of all episodes. Pathogens of acute otitis media were found in 50.0% of subjects under 6 years ol d versus 4.4% of subjects 6 years or over at the first episode (p < .0 01). Pseudomonas aeruginosa was found more often in children 6 years o r older (43.5% versus 20.5% at the first episode, p = .052). Pathogens typical of acute otitis media were less prevalent in the summer month s (14.7% versus 52.2% for the first episode, p = .001), while P aerugi nosa was more prevalent in summer (44.1% versus 16.4% for the first ep isode, p = .006). This suggests that while many younger children with acute otorrhea may respond to treatment with oral antimicrobials alone , outpatient therapy of older children may involve use of topical anti pseudomonal agents that may be complicated by the question of the safe ty of such medications.