Clinical and Sociodemographic Profiles of Patients with Chronic Otitis Media Seeking Health Care at a Tertiary Care Center of Bihar: A Prescription-based Analysis
Swati Suneha, Mukesh Kumar, Kranti Bhavana
Chronic otitis media (COM), Prescription pattern, Prevalence study
Citation Information :
Suneha S, Kumar M, Bhavana K. Clinical and Sociodemographic Profiles of Patients with Chronic Otitis Media Seeking Health Care at a Tertiary Care Center of Bihar: A Prescription-based Analysis. Int J Otorhinolaryngol Clin 2022; 14 (1):7-11.
Objective: To determine the clinical and sociodemographic characteristics of patients with chronic otitis media (COM) at the Department of Otorhinolaryngology, AIIMS, Patna. To deduce the pattern of treatment provided to these patients at this center.
Materials and methods: A cross-sectional observational study was conducted on patients with COM visiting the outpatient department of Otorhinolaryngology, AIIMS, Patna, Bihar, for a period of 6 months (i.e., September 2019 to February 2020). Outpatient prescriptions were collected, and data were recorded and analyzed. Results were interpreted pictorially and through analysis tables. Chi-square test was applied to test the relationship between routes of different antibiotics administration used in the prescriptions.
Results: COM was highly prevalent in males (54.29%), 16- to 40-year age-group (64.76%), and poor to middle-class strata (90.48%). Most cases were unilateral (63.33%) and of COM mucosal subtype (64.76%). Infection (64.28%) and residual/reperforation (24.29%) were major etiological factors. Concomitant sinonasal allergy was present in 69.05% of the patients. The most common symptoms were ear discharge (77.62%) and hearing loss (75.71%). All patients were prescribed antimicrobial-steroid ear drops. Additional drugs prescribed were systemic antibiotics (64%), antihistamines (79.52%), nasal decongestants (70.95%), non-steroidal anti-inflammatory drugs (NSAIDs) (49.05%), and systemic steroids (20.48%). Beta-lactam antibiotics (52%) and cephalosporins (22%) were the most frequently prescribed. The frequency of use of topical along with oral antibiotics was highly significant (p <0.0001) compared to topical with intravenous antibiotics or topical drugs alone.
Conclusion: The study revealed middle-aged males of poor or middle-class socioeconomy forming the majority of patients seeking health care for COM. These patients mostly presented with ear discharge after underlying ear infection that led to a significant hearing loss too. Therefore, topical therapy along with oral antibiotics was the most frequently prescribed on an outpatient basis for prevention and cure.
World Health Organization. Chronic Suppurative Otitis Media–Burden of Illness and Management Options. World Health Organization; 2004. p. 9. Available from: https://www.who.int/pbd/publications/Chronic suppurative otitis_media.pdf.
Acuin J. Global burden of disease due to chronic suppurative otitis media: disease, deafness, deaths and DALYs chronic suppurative otitis media–burden of illness and management options. Geneva: World Health Organisation; 2004. p. 9–23.
Qureishi A, Lee Y, Belfield K, et al. Update on otitis media–prevention and treatment. Infect Drug Resist 2014;7:15–24. DOI: 10.2147/IDR.S39637.
Monasta L, Ronfani L, Marchetti F, et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One 2012;7(4):e36226. DOI: 10.1371/journal.pone.0036226.
Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;386(9995):743–800. DOI: 10.1016/S0140-6736(15)60692-4.
Gupta R, Mittal M. A study on clinical and epidemiological profile of chronic suppurative otitis media (CSOM) at a tertiary care center. Int J Med Sci Public Health 2016;5(5):1021–1024. DOI: 10.5455/ijmsph.2016.18022016360.
Chronic suppurative otitis media–burden of illness and management options. World Health Organization; 2004. p. 14.
Manche SK, Jangala M, Koralla RM, et al. Prevalence of otitis media and its hearing loss in children of South Indian population. 17th International Congress on Infectious Diseases. Int J Infect Dis 2016;45S:1–477. DOI: 10.1016/j.ijid.2016.02.723.
Chandra S, Mohan C, Rahman A. Pattern of hearing impairment in adolescent patients with otitis media. Int J Adv Integ Med Sci 2019;4(2):28–30.
Shaheen M, Raquib A, Ahmad M. Chronic suppurative otitis media and its association with socioeconomic factors among rural primary school going children of Bangladesh. Indian J Otolaryngol Head Neck Surg 2012;64(1):36–41. DOI: 10.1007/s12070-011-0150-9.
Shrestha BL, Shrestha I, Amatya RC. Comparison of clinical presentation between Chronic Otitis Media Mucosal with Squamous. Kathmandu Univ Med J 2010;9(32):387–391. DOI: 10.3126/kumj.v8i4.6237.
Mittal R, Christopher V Lisi, Gerring R, et al. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J Med Microbiol 2015;64(Pt 10):1103–1116. DOI: 10.1099/jmm.0.000155.
Vishwanath S, Mukhopadhyay C, Prakash R, et al. Chronic suppurative otitis media: optimizing initial antibiotic therapy in a tertiary care setup. Indian J Otolaryngol Head Neck Surg 2012;64(3):285–289. DOI: 10.1007/s12070-011-0287-6.
Brennan-Jones CG, Head K, Chong LY, et al. Topical antibiotics for chronic suppurative otitis media. Cochrane Database Syst Rev 2018;2018(6): CD013051. DOI: 10.1002/14651858.CD01.3051.
Head K, Chong LY, Bhutta MF, et al. Antibiotics versus topical antiseptics for chronic suppurative otitis media. Cochrane Database Syst Rev 2020;1(1):CD013056. DOI: 10.1002/14651858.CD013056.pub2.