OBJECTIVES: To assess the antimicrobial susceptibility pattern in chronic suppurative otitis media (CSOM) patients METHODS: A retrospective observational study was conducted for six months in CSOM patients after obtaining the ethical clearance. Patients treated in our hospital during 2012-2014 were included in the study. Demographic details and prescribing pattern of antibiotics were collected from case records. All adult patients who were given antibiotics after the culture sensitivity report were included. The sensitivity and resistance pattern of antibiotics was represented using antibiogram. Data were analysed using spss 20.0 RESULTS: A total of 155 CSOM patients were recruited in the study.    The most frequent causative organism was found to be Pseudomonas followed by MSSA, MRSA, Ecoli ,Acinetobactor, Proteus, Staphylococcus etc. Among the causative organisms, Amoxicillin/Ampicillin was 100 % resistance to MRSA, Acinetobactor, Staphylococcus, E.coli , Citrobactor ,Klebsiella. In  Psuedomonas Piperacillin/Tazobactum was found to be  100 % sensitive in 2012 but was reduced to 96 % in 2013-2014 whereas Cefaperazone/Sulbactum was found to be 0 % sensitive in 2012 but increased to 85 % in 2013 -2014. CONCLUSIONS: Interpretation of the antibiogram have shown that the antimicrobial pattern  in the due course of three years have changed. This development has led to change in the way the antibiotics are prescribed among the CSOM  patients in a tertiary care hospitals. Rational use of antibiotics  may help in reducing the emergence of resistance among CSOM patients in developing countries and this may prevent chance of reoccurrence. Continous surveillance of susceptibility testing is necessary for customization of empiric antibiotic therapy.