Education Of General Practitioners Research Articles

A cross-sectional study of the knowledge, attitude, and practice of general practitioners regarding dog bite management in nothern India

<b>Context:</b> There are many myths and false beliefs associated with wound management. These include application of oils, herbs, and red chilies on wound inflicted by rabid animals, and not washing the wound properly. General practitioners (GPs) constitute a key source of medical care in study area and are approached for anti-rabies treatment by victims of animal bites. <b>Aim:</b> The aim of the present study is to assess the knowledge and practices among the general practitioners (GPs) regarding dog bite management. <b>Settings and Design</b> : Community-based cross-sectional study. <b>Materials and Methods:</b> The present study was carried out in the private and public clinics of Ambala city from January 2012 to April 2012 using a pre-tested self-administered questionnaire. The study population composed of 100 GPs comprising 45 MBBS or above degree holders (Group 1) and 55 other GPs like BAMS, RMPs, etc (Group 2). <b>Statistical Analysis Used:</b> Interpretation of data was done using percentages and proportions. χ² -Test was used to test the statistical difference in the knowledge between the two groups. <b>Results:</b> Out of the total, 68% and 29% respondents in Group 1 and Group 2, respectively, correctly told that wound must be washed with soap and water for minimum period of 15 min. A total 71% and 11% respondents in Group 1 and Group 2, respectively, could correctly answer about the target groups for pre-exposure prophylaxis. A total 62% GPs did not know the high-risk groups to whom pre-exposure prophylaxis has to be given. <b>Conclusions:</b> There was an apparent lack of awareness among the GPs regarding appropriate animal wound management and vaccine administration. Reorientation programs and continued medical education for GPs are required to highlight the WHO guidelines regarding treatment of animal bite.

General practitioners’ knowledge of whiplash guidelines improved with online education

The primary objective of this study was to evaluate the effect of an online education program used to implement the Australian (New South Wales) whiplash guidelines with general practitioners (GP). The secondary aim was to identify factors associated with learning. An online educational and evaluation activity was developed to reflect the key messages for GP from the Australian whiplash guidelines. The educational activity was hosted on the Royal Australian College of General Practitioners' website (www.gplearning.com.au) for a period of 3 years. Participants were recruited through advertisement and media releases. Participants completed a baseline evaluation of their knowledge, participated in the interactive educational activity and completed a post-knowledge questionnaire. The primary outcome was change in professional knowledge, predictors of learning were computed using linear regression. Two hundred and fifteen GP participated. Knowledge significantly improved between baseline and post-knowledge questionnaire scores (P < 0.00001). A total of 57.2% of participants improved their knowledge by more than 20%, indicating a large effect. Low baseline knowledge predicted learning, accounting for 71% of the variance. Online education of GP significantly improved their knowledge in relation to guidelines for whiplash. Those with low baseline knowledge improved their knowledge the most, suggesting that implementation strategies should be targeted at this group.

Physician in practice clinic: educating GPs in endocrinology through specialist-outreach

The escalation in the incidence of diabetes mellitus type 2 requires innovative approaches to manage the increasing burden of service provision, a particularly challenging issue for rural communities. Whereas shared care through specialist outreach clinics is a traditional approach to the management of chronic disease, the results on effectiveness are mixed. Where there is a joint consultation with both the General Practitioner (GP) and specialist present during the patient consultation, benefits are reported; however, this model of specialist outreach is uncommon when compared with the more typical model where a specialist sees the patient alone but at the GP's rooms, and later communicates with the GP. The explicit long-term goal of the Physician in Practice Clinic, which emulates the joint consultation model, is improved patient outcomes through better educated and more confident GPs, easier service access for patients and reduced waiting lists. The education of GPs in endocrinology, an early goal, is the focus of the article. Fifteen GPs were sampled purposively on sex, rural/regional location, place of training, practice size and length of time practising locally. Semi-structured interviews were conducted, transcribed then thematically analysed. General practitioners reported substantial educational benefits. One aspect is the face-to-face contract with the endocrinologist which promotes an interactive learning process. All GPs reported that they acquired new knowledge. An important aspect of this new knowledge is that it could be used quickly, often immediately, and also used in the longer term when generalised for use with other patients. A follow-on effect from the new knowledge and its short- and long-term application was an increase in professional confidence. A benefit with the potential for a long-term effect was improved relationships between the GPs and specialist, and the GPs reporting that they were making fewer referrals. The greatest benefits reported by those in small practices were the interactive learning and being able to generalise the new knowledge to other patients. For rural doctors most benefit was from the interactive learning, whereas for regional doctors it was increased confidence. Australian trained doctors reported mostly the benefits of being able to use the knowledge quickly and the interactive learning. By contrast, doctors not trained in Australia favoured the increased confidence and the generalisability of the new knowledge. Those who had practised locally for up to 10 years benefited most from the new knowledge and the increased confidence, and females benefited most from increased confidence and receiving new knowledge. From the GPs' perspective, the goal of creating better educated and more confident GPs in endocrinology in this rural/regional setting was achieved. Therefore this easily replicated but novel approach to specialist outreach has the potential to improve health outcomes in chronic disease in rural communities. In addition, a more tailored approach to shaping the Clinics based on the socio-demographic categories reported here could have additional short- and long-term benefits.

Views of Patients about Sickle Cell Disease Management in Primary Care: A Questionnaire-Based Pilot Study

ObjectivesTo determine how patients with sickle cell disease (SCD) perceive the quality of care that they receive from their primary healthcare providers.DesignA questionnaire-based pilot study was used to elicit the views of patients about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management.SettingSickle Cell Society and Sickle Cell and Thalassaemia Centre, in the London Borough of Brent.ParticipantsOne hundred questionnaires were distributed to potential participants with SCD between November 2010 and July 2011 of which 40 participants responded.Main outcome measuresAnalysis of 40 patient questionnaires collected over a nine-month period.ResultsMost patients are generally not satisfied with the quality of care that they are receiving from their primary healthcare providers for SCD. Most do not make use of general practitioner (GP) services for management of their SCD. Collecting prescriptions was the reason most cited for visiting the GP.ConclusionGPs could help improve the day-to-day management of patients with SCD. This could be facilitated by local quality improvement schemes in areas with high disease prevalence. The results of the survey have been used to help develop a GP education intervention and a local enhanced service to support primary healthcare clinicians with SCD's ongoing management.

Delivery Strategies to Optimize Resource Utilization and Performance Status for Patients With Advanced Life-Limiting Illness: Results From the “Palliative Care Trial” [ISRCTN 81117481

ContextEvidence-based approaches are needed to improve the delivery of specialized palliative care. ObjectivesThe aim of this trial was to improve on current models of service provision. MethodsThis 2×2×2 factorial cluster randomized controlled trial was conducted at an Australian community-based palliative care service, allowing three simultaneous comparative effectiveness studies. Participating patients were newly referred adults, experiencing pain, and who were expected to live >48 hours. Patients enrolled with their general practitioners (GPs) and were randomized three times: 1) individualized interdisciplinary case conference including their GP vs. control, 2) educational outreach visiting for GPs about pain management vs. control, and 3) structured educational visiting for patients/caregivers about pain management vs. control. The control condition was current palliative care. Outcomes included Australia-modified Karnofsky Performance Status (AKPS) and pain from 60 days after randomization and hospitalizations. ResultsThere were 461 participants: mean age 71 years, 50% male, 91% with cancer, median survival 179 days, and median baseline AKPS 60. Only 47% of individuals randomized to the case conferencing intervention received it; based on a priori-defined analyses, 32% of participants were included in final analyses. Case conferencing reduced hospitalizations by 26% (least squares means hospitalizations per patient: case conference 1.26 [SE 0.10] vs. control 1.70 [SE 0.13], P=0.0069) and better maintained performance status (AKPS case conferences 57.3 [SE 1.5] vs. control 51.7 [SE 2.3], P=0.0368). Among patients with declining function (AKPS <70), case conferencing and patient/caregiver education better maintained performance status (AKPS case conferences 55.0 [SE 2.1] vs. control 46.5 [SE 2.9], P=0.0143; patient/caregiver education 54.7 [SE 2.8] vs. control 46.8 [SE 2.1], P=0.0206). Pain was unchanged. GP education did not change outcomes. ConclusionA single case conference added to current specialized community-based palliative care reduced hospitalizations and better maintained performance status. Comparatively, patient/caregiver education was less effective; GP education was not effective.

Adherence to COPD guidelines in general practice: impact of an educational programme delivered on location in Danish general practices

The general practitioner (GP) is often the first healthcare contact for patients with chronic obstructive pulmonary disease (COPD). To determine whether participating in a standardised educational programme delivered in the GP's own practice is associated with adherence to COPD guidelines. A nationwide register-based observational before and after study was undertaken with a control group of propensity-matched practices (follow-up period 6 months). COPD was defined as age 40+ years and at least two prescriptions for inhaled medication. The educational programme consisted of a 3-hr teaching lesson with a respiratory specialist and five visits by a representative from the sponsoring pharmaceutical company focusing on assessment and management of patients including written algorithms. A one-to-one propensity-matched control group of practices was selected. Register data were used to compare the rate of spirometry testing, preventive consultations, and influenza vaccinations provided to COPD patients and the rate of spirometry testing in non-COPD individuals, assumed to reflect diagnostic activity. Data for 102 participating GP practices were analysed. Participating clinics had a significant increase in preventive consultations and influenza vaccinations (p<0.05). For the control group, a significant change was observed only for influenza vaccinations. No significant change was found when comparing participating and control clinics in the difference-in-difference estimator. However, a significant improvement was observed for the subgroup of 48 clinics with the lowest starting point of spirometry testing. Focused education of GPs and their staff delivered in the GPs' own practices may improve adherence to COPD guidelines, not least for clinics with a high potential for improvement.

State of psychiatry in Serbia – Problems, advances and perspectives

Serbia has been exposed to many severe stressors during the last 20 years and as a result there is an increase of the incidence of mental health problems in its population, so that mental disorders are the second largest public health problem, after cardiovascular diseases. The National Strategy for Development of Mental Health Care was approved by the government in January 2007 which initiated the reform of psychiatry in the country. The major advantages of the existing organization of mental healthcare are a sufficient number of psychiatric services and the number of well educated professionals, but there are considerable problems in big psychiatric hospitals which are significantly overcrowded with patients, as well as with the lack of a network of community services. In the future, key points of mental health reform aim to focus on improved cooperation and collaboration between primary, secondary and tertiary healthcare levels, definition of catchment areas and responsibilities, continuing education of general practitioners in mental health issues, and better cooperation between psychiatric and social welfare institutions. The profile of the Institute for Mental Health is described as a case of good practice in the field of mental healthcare in Serbia.

Family planning and inflammatory bowel disease: the patient and the practitioner

Patients with inflammatory bowel disease (IBD) are commonly in their child-bearing years. Maintainance medication, as recommended by international guidelines, is an emotive topic and an anxiety source. This study measures the awareness of patients and primary practitioners of the issues involved. A prospective questionnaire was sent to female patients (18-50 years) with an IBD diagnosis in Kerry General Hospital, Ireland, who were identified from radiology and pathology databases. A seperate questionnaire was sent to General Practitioners (GPs) in the region. About 31 female patients (42%) and 49 GPs (43%) returned completed questionnaires. About 29% had Crohn's disease and 71% ulcerative colitis. A total of 42% of patients would allow having IBD or its treatment to influence decisions about family planning. Most patients were on maintainance medications. Despite this, 68% had not discussed family planning with a doctor. One-third believed all medications should be stopped during pregnancy and 68% reported significant anxiety about future pregnancies. A total of 68% GPs report regular contact with IBD patients, but consultations with pregnant IBD patients are less frequent. About 41% of GPs have not opportunistically raised family planning with this patient group and 67% would refer to a tertiary specialist for advice. About 2% of GP's had need to research the topic in the last 12 months. There is a significant patient knowledge deficit about pregnancy and IBD resulting in unwarranted fears and anxiety. Further evidence based education for GP's with increased gastroenterologist/IBD nurse specialist support should maximize exploitation of health promotion opportunities to electively address this issue.

The GIANT study, a cluster-randomised controlled trial of efficacy of education of doctors about type 2 diabetes mellitus management guidelines in primary care practice

ObjectivesPrimary aim: does general practitioner (GP) education on type 2 diabetes treatment improve HbA1c? Secondary aim: cardiovascular risk factors, hypoglycaemia, treatment intensification, health service utilisation, treatment barriers. Methods99 Asia-Pacific GPs were cluster-randomised to be educated on regional diabetes management guidelines (intervention) or continue standard care (control). The intervention employed meetings, reminders, medical record summary sheets and patient result cards. Each GP recruited four type 2 diabetic patients, assessed at baseline, 6 and 12 months. The primary outcome was mean change in HbA1c from 0 to 6 months in patients with baseline HbA1c≥6.5%. Results361 patients (93%) completed 6 month follow-up. The primary HbA1c outcome was −0.11% (95% CI −0.27, 0.05) with intervention and −0.22% (95% CI −0.39, −0.05) in the control group (p=0.340). The groups did not differ in control of other glycaemic indices, blood pressure or lipids after 6 or 12 months. In those with HbA1c≥9.0%, approximately 50% received intensified treatment by 6 months, and 30% in the final 6 months. GPs identified treatment costs and patient reluctance to use insulin as management barriers. Conclusions/interpretationA structured GP education programme did not improve HbA1c in patients with type 2 diabetes.

A Randomized Trial to Reduce the Prevalence of Depression and Self-Harm Behavior in Older Primary Care Patients

We wanted to determine whether an educational intervention targeting general practitioners reduces the 2-year prevalence of depression and self-harm behavior among their older patients. Our study was a cluster randomized controlled trial conducted between July 2005 and June 2008. We recruited 373 Australian general practitioners and 21,762 of their patients aged 60 years or older. The intervention consisted of a practice audit with personalized automated audit feedback, printed educational material, and 6 monthly educational newsletters delivered over a period of 2 years. Control physicians completed a practice audit but did not receive individualized feedback. They also received 6 monthly newsletters describing the progress of the study, but they were not offered access to the educational material about screening, diagnosis and management of depression, and suicide behavior in later life. The primary outcome was a composite measure of clinically significant depression (Patient Health Questionnaire score ≥10) or self-harm behavior (suicide thoughts or attempt during the previous 12 months). Information about the outcomes of interest was collected at the baseline assessment and again after 12 and 24 months. We used logistic regression models to estimate the effect of the intervention in a complete case analysis and intention-to-treat analysis by imputed chain equations (primary analysis). Older adults treated by general practitioners assigned to the intervention experienced a 10% (95% CI, 3%-17%) reduction in the odds of depression or self-harm behavior during follow-up compared with older adults treated by control physicians. Post hoc analyses showed that the relative effect of the intervention on depression was not significant (OR = 0.93; 95% CI, 0.83-1.03), but its impact on self-harm behavior over 24 months was (OR = 0.80; 95% CI, 0.68-0.94). The beneficial effect of the intervention was primarily due to the relative reduction of self-harm behavior among older adults who did not report symptoms at baseline. The intervention had no obvious effect in reducing the 24-month prevalence of depression or self-harm behavior in older adults who had symptoms at baseline. Practice audit and targeted education of general practitioners reduced the 2-year prevalence of depression and self-harm behavior by 10% compared with control physicians. The intervention had no effect on recovery from depression or self-harm behavior, but it prevented the onset of new cases of self-harm behavior during follow-up. Replication of these results is required before we can confidently recommend the roll-out of such a program into normal clinical practice.

Transient Ischaemic Attack (TIA) Knowledge in General Practice: a cross-sectional study of Western Adelaide general practitioners

BackgroundWith evidence to support early assessment and management of TIAs, the role of the general practitioner (GP) needs to be considered in developing a TIA service in Western Adelaide. We thus aimed to determine GP knowledge of TIA assessment and management and identify perceived barriers, in order to tailor subsequent GP education and engage primary care in the co-ordinated care of TIA patients.FindingsA self-administered questionnaire was mailed to all GPs (n = 202) in the Adelaide Western General Practice Network. Response frequencies were calculated for all variables, and associations examined by univariate analysis.32 GPs responded. All respondents correctly identified early risk of stroke following a TIA. Difficulty accessing neurological expertise was identified as a barrier (40.6 %), as was a lack of GP knowledge (18.8 %). Areas for improvement included access to neurologists (36.7 %), relevant guidelines and education (43.3 %).ConclusionsDiagnosis of TIA is difficult and this study highlights the need for further education and practical guidelines for GPs. With this training, GPs could be better equipped to assess and manage TIAs effectively in the community in consultation with stroke physicians.

Targeted education for general practitioners reduces risk of depression or suicide ideation or attempts in older primary care patients

Targeted education for general practitioners reduces risk of depression or suicide ideation or attempts in older primary care patients

Public health actions to improve palliative care in Germany: Results of a three-round Delphi study

BackgroundIn previous studies, key targets for public health initiatives to improve palliative care in Germany were defined. The aim of this study was the identification and prioritisation of actions to achieve these targets. MethodsA three-round Delphi study with 107 stakeholders acting on the meso and macrolevel of the healthcare system was undertaken. First round: proposing actions for each of the key targets; second round: assessment of the actions regarding their relevance; third round: ranking of the actions. Results37 actions were generated (first round) of which 14 actions were rated as relevant (second round). In the third round, the action ranked highest was “close collaboration between specialist palliative care services, general practitioners and community nursing services”, followed by “Implementing specialist palliative care in the community consequently” and “Strengthening generalist palliative care through training and education of general practitioners and nursing services”. ConclusionsThe range and the ranking of the actions provide an empirical basis to improve palliative care in Germany on different levels of policy, education and clinical practice. A focus should be on strengthening the collaboration between primary health care providers and specialist palliative care services.

Primary care intervention programme to improve early detection of hearing loss in the elderly

To improve audiology screening in general practice, using an intervention programme aiming to empower older adults and their general practitioners. We conducted a quasi-experimental community study comparing 206 patients and two control groups (the first being 101 people registered with the same general practitioner, and the second 87 people registered with another general practitioner). Outcome measures were: rates of hearing tests in the six months before interview, and screening recommendation by the general practitioner. Amongst patients, there was a significant increase in numbers undergoing a hearing test, from 19 per cent before the intervention to 49 per cent two years later, while in the two control groups there was little change. Twenty-two per cent of patients and 19 per cent of the first control group reported that their physicians suggested undergoing a hearing test; the second control group subjects (whose general practitioners received no specific educational intervention) showed no change. The two crucial factors for improving hearing screening uptake in the elderly are general practitioner education and patient empowerment.

Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period.MethodsTwo Indonesian GPs visited 31 Primary Health Care Centres (PHCCs) and provided a lecture on NPC. The alternative format consisted of a symposium at the Universitas Indonesia, Jakarta, presented by local head and neck surgeons, with all GPs in the region being invited. To evaluate the effect of both formats a questionnaire was conducted before and after.ResultsThe lecture in the PHCCs was attended by 130 GPs. Sixty-six GPs attended the training in the university hospital and 40 GPs attended both. Pre training the NPC knowledge level was poor with an average of 1.6 symptoms being correctly identified out of a potential maximum of 12, this was increased to 4.9 post training (p<0.0001). GPs attending the PHCC course recorded a greater increase in correct symptoms than those attending the symposium (3.8 vs. 2.8; p = 0.01). After a two week period the knowledge levels had declined slightly from 5.5 correctly identified symptoms to 4.2 (p = 0.25).ConclusionThese results confirm our findings regarding GPs insufficient knowledge of NPC. Lectures in the PHCC and a symposium have both been proven to be effective training tools in the education of GPs.

Prioritization of future genetics education for general practitioners: a Delphi study

PurposeGeneral practitioners (GPs) are increasingly expected to deliver genetics services in daily patient care. Education in primary care genetics is considered suboptimal and in urgent need of revision and innovation. The aim of this study was to prioritize topics for genetics education for general practice. MethodsA Delphi consensus procedure consisting of three rounds was conducted. A purposively selected heterogeneous panel (n = 18) of experts, comprising six practicing GPs who were also engaged in research, five GP trainers, four clinical genetics professionals, and three representatives of patient organizations, participated. Educational needs regarding genetics in general practice in terms of knowledge, skills, and attitudes were rated and ranked in a top-10 list. ResultsThe entire panel completed all three rounds. Kendall's coefficient of concordance indicated significant agreement regarding the top 10 genetic education needs (P < 0.001). “Recognizing signals that are potentially indicative of a hereditary component of a disease” was rated highest, followed by “Evaluating indications for referral to a clinical genetics centre” and “Knowledge of the possibilities and limitations of genetic tests.” ConclusionsThe priorities resulting from this study can inform the development of educational modules, including input for case-based education, to improve GP performance in genetic patient care.

To Drive or Not to Drive: Assessment Dilemmas for GPs

Introduction. Most Australians are dependent on their cars for mobility, thus relinquishing driving licences for medical reasons poses challenges. Aims. To investigate how general practitioners (GPs) recognise and manage patients' fitness to drive, GPs' attitudes and beliefs about their role as assessors, and GPs' experiences in assessing and reporting to driving authorities and identify GPs' educational needs. Methods. Mixed methods: questionnaire mailed to GPs from three rural and two metropolitan Divisons of General Practice in Victoria, Australia. Results. 217/1028 completed questionnaires were returned: 85% recognised a patients' fitness to drive, 54% felt confident in their assessment ability, 21% felt the GP should have primary responsibility for declaring patients' fitness to drive, 79% felt that reporting a patient would negatively impact on the doctor-patient relationship, 74% expressed concern about legal liability, and 74% favoured further education. Discussion. This study provides considerable information including recommendations about GP education, the assessment forms, and legal clarification.

General practitioners' patterns of treatment of febrile travellers in north Queensland: an exploratory study

In north Queensland, recurring epidemics of dengue fever are a public health concern. Each epidemic is initiated by an index case: an infected person arriving from an endemic country or region with dengue activity who then transmits the disease to local mosquitoes. A timely diagnosis of dengue in an index case and notification to public health services is essential to prevent epidemics. This qualitative study explores north Queensland general practitioners' experiences and patterns of treatment of febrile travellers. Individual, semi-structured interviews with 50 general practitioners working in north Queensland were conducted. Analysis of the data resulted in four themes for discussion: characteristics of febrile travellers presenting to local general practitioners, the cost of pathology tests as a barrier to diagnosis, appropriate pathology testing, and notifying tropical public health services. Recommendations from this study point to a need for ongoing education and training for general practitioners in best practice with regards pathology testing for suspected dengue fever cases. As well, there is a need to provide clearer guidelines to general practitioners on when to notify tropical public health services of suspicious diagnoses of dengue.

Herausforderungen und Potenziale hausärztlicher Versorgung in einer multikulturellen Gesellschaft

The greatest proportion of basic health care for patients with a migrational background living in Germany is provided by general practitioners. There is evidence that patients with a migrational background see a general practitioner as a gate keeper in case of physical or mental complaints even more frequently than the native German population. In contrast, the impact of migration-specific tasks in general practice appears to be relatively low in the medical and public discourse. This article analyzes the current situation of medical care for migrant patients in general practice and shows its potential to offer low-threshold high quality health care services to migrant patients and the whole population. In addition, an overview on migration-specific issues in research, teaching, and continuous medical education of general practitioners is provided. Finally, the implications of these findings for future research questions on migration-sensitive interventions are discussed.

Pattern of Chronic Suppurative Otitis Media at the National Ear Care Centre Kaduna, Nigeria

Background: Chronic suppurative otitis media constitutes a major cause of otorhinolaryngological clinic visits in Nigeria, therefore it is pertinent to determine the local pattern of presentation in order to achieve adequate treatment, avoid complications and provide records for future references.Methodology: A retrospective review of patients presenting with chronic suppurative otitis media to the out-patient clinic of the National Ear Care Center, Kaduna within a period of 1 year.Results: One hundred and forty six patients presented, accounting for 3.8% of the total number of patients and 6.6% of all otological cases. One hundred and twenty eight (87.7%) case notes were retrievable and studied. Patients were aged 1 year to 82 years (mean=19.2 years) with 67 males and 61 females giving a gender ratio of 1.1:1. Children under 10 years constituted the majority (n=64). Tympanic membrane perforation was central in 117 (67.6%), marginal in 38 (22%) and attic in 18(10.4%) patients. Positive culture occurred in 75 (58.6%), no growth in 22 (17.2%) patients and there was no record of ear swab or culture in 31 (24.2%) patients. Bacterial isolates were Klebsiella specie (n=31, 41.3%), Escherichia coli (n=22, 29.3%), Streptococcus specie (n= 8, 10.8%), Staphylococcus aureus (n=7, 9.3%), Pseudomonas aeruginosa (n=6, 8%) and Proteus specie (n=1, 1.3%). Antimicrobial sensitivity was highest to the quinolones (57.9%). Ninety-four (73.4%) patients achieved dry ears in the first month. The complication rate was 6.3%.Conclusion: We recommend the quinolone antibiotics as first line drugs in treatment of chronic suppurative otitis media and continuing medical education of general practitioners and pediatricians especially those practicing in the rural areas on the management of CSOM is important to improve the outcome.