WHAT IS THE NATURAL-HISTORY OF RECURRENT ACUTE OTITIS-MEDIA IN INFANCY

BACKGROUND. Chemoprophylaxis or tympanostomy tubes are often recommend ed for recurrent acute otitis media because of the associated morbidit y, temporary hearing loss, financial costs, and risks of middle-ear se quelae. The aim of this study was to study the natural course of recur rent acute otitis media in infancy without such prophylactic treatment . METHODS. Two hundred twenty-two children who had recurrent acute oti tis media and received no prophylaxis were monitored for subsequent ac ute otitis media and the development of chronic otitis media with effu sion. RESULTS. Only 4% of the 222 infants with recurrent acute otitis media developed chronic otitis media with effusion and an additional 1 2% continued having recurrent episodes. The most significant factor pr edicting an increased risk of recurrence was young age (<16 months of age). Attending day care and having siblings had a less pronounced eff ect. CONCLUSIONS. Spontaneous recovery from recurrent otitis media is common with increasing age. Thus, until reliable casual evidence betwe en recurrent otitis media and developmental disability is presented, c hemoprophylaxis or tympanostomy tubes seem superfluous for most infant s after the age of 16 months.