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To the Editor: Dr Paradise and colleagues¹ describe an effective way to reduce the incidence of recurrent acute otitis media (AOM) by more than 50%: be patient. Children entering their study initially had 4 or more annual AOM episodes, yet averaged 2.1 episodes during their first year as nonsurgical controls. Furthermore, only about one third remained susceptible to otitis (at least 3 annual episodes) and more than 20% had no AOM. Similarly, control groups in antimicrobial prophylaxis trials have a favorable prognosis. Children randomized to placebo in 13 randomized studies averaged 1.6 annual AOM episodes, a decrease from baseline of about 2.0 episodes per year.² During a median period of 6 months only 13% had 3 or more AOM episodes and 51% had no further AOM.

These findings suggest a favorable prognosis for most children with recurrent AOM, provided that the patients do not have prior tympanostomy tubes or any . . . [Full Text of this Article]

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RELATED ARTICLE

Adenoidectomy and Adenotonsillectomy for Recurrent Acute Otitis Media: Parallel Randomized Clinical Trials in Children Not Previously Treated With Tympanostomy Tubes
Jack L. Paradise, Charles D. Bluestone, D. Kathleen Colborn, Beverly S. Bernard, Clyde G. Smith, Howard E. Rockette, and Marcia Kurs-Lasky
JAMA. 1999;282(10):945-953.
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