What is the natural history of recurrent acute otitis media in infancy?

Abstract

Background: Chemoprophylaxis or tympanostomy tubes are often recommended for recurrent acute otitis media because of the associated morbidity, temporary hearing loss, financial costs, and risks of middle-ear sequelae. The aim of this study was to study the natural course of recurrent acute otitis media in infancy without such prophylactic treatment.

Methods: Two hundred twenty-two children who had recurrent acute otitis media and received no prophylaxis were monitored for subsequent acute otitis media and the development of chronic otitis media with effusion.

Results: Only 4% of the 222 infants with recurrent acute otitis media developed chronic otitis media with effusion and an additional 12% continued having recurrent episodes. The most significant factor predicting an increased risk of recurrence was young age (< 16 months of age). Attending day care and having siblings had a less pronounced effect.

Conclusions: Spontaneous recovery from recurrent acute otitis media is common with increasing age. Thus, until reliable causal evidence between recurrent otitis media and developmental disability is presented, chemoprophylaxis or tympanostomy tubes seem superfluous for most infants after the age of 16 months.