Objective: Active chronic suppurative otitis media (CSOM) is the bacterial chronic infection of middle ear cleft mucosa and treated with antibiotics empirically, which may cause resistance to bacterial strains. In this study, we studied the bacteriology and susceptibility pattern in CSOM for efficient empirical treatment especially in central India. Methods: Clinically proven 160 patients with CSOM with otorrhea, were included in our study. Ear discharge samples were collected with the asepsis method and bacterial culture and antibiotics sensitivity patterns were obtained. Results: Bacterial growth was present in 76.1% of ear samples with Staphylococcus and Pseudomonas being most prominent. Vancomycin and Rifampicin were most effective for staphylococcus and amoxicillin and quinolones were most resistant. Meropenem and Piperacillin/tazobactam were the most effective antipseudomonal antibiotics. Ciprofloxacin and Levofloxacin were least sensitive antipseudomonal quinolones. Conclusion: Amoxicillin with quinolones were highly resistant for bacterial growth in-ear samples so used cautiously as empirical therapy in CSOM. For effective treatment of CSOM and prevention of resistant strain emergence, all ear samples must be sent for culture sensitivity