The frequency of detection of drug-resistant Streptococcus pneumoniae (DRSP) infections has decreased after the introduction of the pneumococcal conjugate vaccine (PCV). This study was aimed at investigating the changes in the DRSP detection trends among cases of acute otitis media (AOM) in adults following introduction of the PCV. The study population included 135 adults with S. pneumoniae was detected in middle ear fluid specimens obtained through myringotomy between 2000 and 2009 (period I, before introduction of the PCV) and 75 adults with S. pneumoniae detected in middle ear fluid specimens obtained by myringotomy between 2013 and 2022 (period II, 3 years after introduction of the PCV). Throughout both the phases, penicillin antibiotics (PCs) were the treatment of first-choice for upper respiratory infections at our institution and nearby medical facilities. The results showed a significant decrease in the detection frequency of DRSP after introduction of the PCV and an improvement in the susceptibility of the pathogens to amoxicillin. Prior to introduction of the PCV, significant differences were noted in drug susceptibilities to PCs based on cohabitation with children in group childcare settings and the age groups of the cohabitating children (cases cohabitating with and not cohabitating with children under 2 years old). However, these differences disappeared after introduction of the PCV. The study also confirmed a reduction in the number of adult cases of AOM after introduction of the PCV and a significant decrease in the proportion of adult cases of AOM caused by S. pneumoniae requiring myringotomy. While herd immunity from the PCV was suggested, further research is needed to investigate the relationship between the serotypes covered by PCV, the non-covered serotypes, and the serotypes of S. pneumoniae detected in adult cases of AOM.

　　Re-entering the workforce by veteran physicians is expected to address the shortage and maldistribution of physicians. The Working Group on the Training and Utilization of Specialists in Otolaryngology and Head and Neck Surgery plans to establish a senior doctors bank through the Society. To obtain basic information on veteran physicians' intentions regarding second careers, we conducted a survey in January 2023 of members aged 40 years or older. Responses were obtained from 598 general practitioners and 705 hospital physicians. Among the general practitioners, 26% had plans to close their clinics, and of these, 57% were willing to return to the profession if their wishes were met. In contrast, 68% of hospital physicians had no intention of opening their own clinics, 45% expected to continue to work at their current jobs until retirement, and 74% hoped to reenter the workforce after retirement. The younger hospital physicians (odds ratio: OR 0.16) and the less satisfied they were with their current job (OR 0.59), the more likely they were to want to open their own private practice. A significantly higher percentage of hospital physicians (59.6%) preferred to become members of the senior doctors bank as compared to 11.9% of general practitioners. Furthermore, about half (49.9%) of the hospital physicians wanted to continue to perform surgery or teach surgical techniques. This is expected to be a valuable workforce with expertise in regions and facilities where there is a shortage of physicians to perform surgery and teach surgical techniques. In order to support the re-entry of veteran physicians into the workforce, it is important to offer them attractive work, including surgeries and opportunities to teach surgical techniques.