In the pediatric group practice and the otolaryngologic practice of our rural community, 41 patients were seen in 1984 with 49 episodes of suppurative discharge after tympanostomy tube insertion. Streptococcus pneumoniae was the most common organism after upper respiratory tract infection. Staphylococcus or enteric organisms were most frequently encountered after bathing or swimming. Most patients regained hearing within normal limits. The benefits of tympanostomy tubes in terms of good hearing and reduced incidence of suppurative otitis media outweigh the risk of transitory suppuration for most patients.