Culture targeted antibiotic for otorrhea complicating tympanostomy tube

Abstract Background Tympanostomy tubes are used for persistent or recurrent otitis media but are often complicated by otorrhea (25–75%). Treatment relies on culture-guided topical and/or systemic antibiotics, though biofilm formation may cause recurrence after therapy. The present work aimed to assess the efficacy of culture-targeted antibiotic treatment for otorrhea complicating tympanostomy tube placement. Methods This cohort case series study included 50 patients, aged 2 to 51 years, of both sexes, who presented postoperatively with otorrhea and had a tympanostomy tube (grommet tube or T-tube) in place. All patients underwent otorhinolaryngological clinical examination and evaluation of Otorrhea. Results Grommet tubes were used in 80% of patients, mainly in the antero-inferior position, with adenoid hypertrophy accounting for 76% of effusions. Infections developed after ~ 3 months, presenting with mucopurulent discharge; Haemophilus influenzae was the most common (30%). Combined local and systemic antibiotics resolved symptoms in ~ 11 days, with a 14% recurrence rate. Sensitivity varied by organism, and recurrent otorrhea, often due to biofilm formation, resolved with tube removal in most cases, though one persistent perforation remained. Conclusions Culture-targeted therapy is effective in managing otorrhea, preventing complications of tympanostomy tube placement, and preventing discharge recurrence. Identifying specific pathogens, including Hemophilus influenzas, Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus epidermidis, enabled targeted antibiotic therapy associated with high treatment success. The most common organism associated with recurrent discharge was Pseudomonas infection.