Eur Arch Otorhinolaryngol (2010) 267:501–505 DOI 10.1007/s00405-009-1082-9 123 OTOLOGY Ear microbiology reports: a need for better communication with the microbiologists Eu Chin Ho · Gaurav Chawdhary · Aaisha Khan · Stephen G. Jones · Mark Simmons Received: 28 June 2009 / Accepted: 18 August 2009 / Published online: 16 September 2009  Springer-Verlag 2009 Abstract Most ENT surgeons treat discharging ears with topical antibiotics but many may not routinely utilise ear microbiology specimens. One reason could be that ear microbiology reports may not reXect their usual therapeutic options. This paper explores how microbiology depart- ments in England process ear swabs. We carried out a tele- phone questionnaire of 104 microbiology departments in England. Results were obtained from 95 hospitals. Various culture methods are used, with sensitivity testing for up to 51 diVerent antibiotics. Only Wve are licensed for topical use. Systemic antibiotics seemed to be preferentially tested for over topical antibiotics. Anaerobes and fungus are rou- tinely tested. Many microbiology departments do not rou- tinely report on all sensitivities tested. Antibiotic sensitivity testing for various micro-organisms cultured from ear swabs seemed to be guided by protocols for systemic infec- tions. Microbiologists may not fully appreciate ENT sur- geons’ preferential usage of topical antibiotics in treating discharging ears, albeit there are other factors in their con- sideration for antibiotics to test. To gain better guidance from swab results, and to reduce needless lab costs, discus- sion with the microbiologists may be of beneWt. Keywords Microbiology · Culture techniques · Bacteria · Otitis media · Otitis externa Introduction There is good evidence that topical antibiotic treatment is superior to systemic antibiotic treatment in cases of uncompli- cated ear infection with discharge, whether Otitis externa or Otitis media with perforation [1]. Indeed, the American Acad- emy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has produced a clinical practice guideline rec- ommending topical antibiotics as the Wrst line treatment in the management of uncomplicated discharging ears [2]. Most United Kingdom (UK) ENT surgeons prefer treat- ing discharging ears with topical antibiotic preparations but many may not routinely send oV ear microbiology speci- mens prior to the initiation of treatment [3]. One possible reason could be that ear microbiology reports do not always reXect their usual therapeutic options. It seems that many microbiology departments preferentially test ear swabs against systemic antibiotics rather than topical ones. This paper explores how microbiology departments in England process ear microbiology swabs. Methods We identiWed 104 hospitals in England that have ENT departments and contacted their microbiology departments. We carried out a telephone questionnaire that lasted between 5 and 7 min. A copy of the questionnaire is enclosed as Appendix 1. Results Results were obtained from 95 hospitals giving a response rate of 91%. A wide variety of culture/sensitivity methods E. C. Ho (&) · A. Khan · S. G. Jones · M. Simmons Manor Hospital, Moat Rd, Walsall WS2 9PS, UK e-mail: euchinho@yahoo.co.uk E. C. Ho 59 Spiceland Road, Birmingham B31 1NL, UK G. Chawdhary University of Birmingham, Birmingham, UK