II. Prevention: Recurrent Otitis Media
- Influenza Vaccine annually
-
Pneumococcal Conjugate Vaccine (e.g. Prevnar 13)
- Reduces Incidence of pneumococcal Otitis Media
- Jacobs (2002) J Pediatr 141:287-93 [PubMed]
- Eliminate passive Tobacco smoke exposure
- Avoid bottle propping
- Avoid Pacifiers
- Consider diagnosis and management of comorbid chronic Allergic Rhinitis
- Xylitol gum
- Consider in children with recurrent Otitis Media and old enough to chew gum
- Chew 2 pieces for at least 5 minutes each, 5 times daily after meals
- Azarpazhooh (2011) Cochrane Database Syst Rev (11): CD007095 [PubMed]
-
Tympanostomy Tube indications
- Three Otitis Media episodes in 6 months OR 4 episodes in 1 year AND
- Last episode within prior 6 months
III. Prevention: Strategies not found effective (avoid these for Otitis Media Prevention)
-
Probiotics
- Not effective in URI or Otitis Media Prevention
- Probiotics are effective to prevent Antibiotic Associated Diarrhea
- Weichert (2012) Pediatr Infect Dis 31(8): 859-62 [PubMed]
IV. Protocol: Antibiotic Prophylaxis for Recurrent Otitis Media (not recommended, historical purpose only)
- Antibiotic prophylaxis is largely replaced by Tympanostomy Tubes
- Antibiotics prophylaxis for recurrent Otitis Media is not recommended
-
Antibiotic prophylaxis reduced recurrent Otitis Media episodes by 50%, but at the expense of Antibiotic Resistance
- Antibiotic prophylaxis selects for Antibiotic resistant Streptococcus Pneumoniae
-
Antibiotics were previously indicated for
- Three distinct Otitis Media episodes in 6 months
- Four distinct Otitis Media episodes in 12 months
- Prior protocols use Amoxicillin or Sulfisoxazole for up to 6 months