만성 중이염의 술후 감염 발생 환자에 대한 항생제 선택에 대한 고찰

Abstract

Background and Objectives Few studies have been reported on the strains that cause post-operative infection after chronic otitis media (COM) surgery. This study examined the direc-tion of empirical antibiotics selection for patients with postoperative infection. Subjects and Method This was a retrospective study of 33 patients who were admitted forantibiotics therapy after suffering intractable post-operative infection of COM surgery at Chon-nam National University Hospital from 2011 to 2021. Demographic data and microbial cultureresults of pre-operation and post-operative infection, as well as selected antibiotics for differenttime periods were evaluated. Results Most common pathologic organisms responsible for post-operative infection wereMethicillin-resistant Staphylococcus aureus (MRSA) (45.5%) and Ciprofloxacin-resistant Pseu-domonas aeruginosa (CRPA) (12.1%). Interestingly, there were only three cases where pre- andpost-operative culture tests were the same, testing positive for two MRSA and one CR PA. Theantibiotics selected as empirical antibiotics for postoperative infection were ceftazidime (48.5%)and vancomycin (27.3%). The rate of the cases where the selected empirical antibiotic was sen-sitive to the strain was 63.6%, and the rate of changing the antibiotics according to the micro-bial culture test result was 39.4%. Conclusion The strains cultured from the otorrhea of post-operatively infected patients hada very high ratio of drug-resistant strains and were different from the strains cultured from theotorrhea before surgery. Therefore, a microbial culture test is essential when an infection oc-curs after surgery, and regardless of the preoperative culture test results, patients with intrac-table postoperative infections should be treated with empirical vancomycin.