Management of recurrent otitis media.

Recurrent otitis media is defined as three or more episodes of acute otitis media in six months or four or more episodes in one year, with the bouts of acute infection separated by intervals of full resolution. The disorder is common in children and is different from otitis media with effusion, the other frequently encountered chronic ear disease. Daily low-dose antibiotic therapy is recommended as initial prophylaxis against recurrent otitis media. Pressure-equalizing tubes may be used in patients who have more than one episode of breakthrough otitis media while receiving antibiotics. Adenoidectomy should be reserved for use when pressure-equalizing tubes fail or when insertion of a second set of tubes is required.