title: Recurrent acute otitis media in infants: analysis of risk factors.
abstract: OBJECTIVE
  Recurrence acute otitis media (RAOM) may cause a considerable morbidity and a great parental concern. The aim of this study was to analyze the risk factors that are likely to be responsible for RAOM in infants, and their impact on treatment failure.
  
  
  METHODS
  A retrospective study on 340 infants with RAOM was conducted. Data were collected from hospital charts. A 10 days course of amoxicillin/clavulanate was used for treatment of recurrence, while surgical management in the form of adenoidectomy and/or myringotomy was reserved for patients with persistent disease. We analyzed various risk factors that may affect the prognosis of RAOM, including: age, prematurity, upper respiratory tract infections (URTI), duration of breastfeeding, use of pacifiers, parental smoking, seasonality, the presence of siblings (family size), gender, adenoid hypertrophy, allergy, and craniofacial abnormalities.
  
  
  RESULTS
  Use of pacifiers, short duration of breastfeeding, older infantile age, winter season, URTI and presence of adenoid hypertrophy were identified as risk factors for RAOM. Treatment failure may be due to adenoid hypertrophy, short duration of breastfeeding and it is more common in older age infants. We did not find a significant association between RAOM and gender, prematurity, exposure to passive smoking, the presence of siblings, allergy, craniofacial abnormalities.
  
  
  CONCLUSIONS
  Factors that may cause recurrence of the disease in infant population are use of pacifiers, short duration of breastfeeding, older infantile age, winter season, upper respiratory tract infections and adenoid hypertrophy. Also, treatment failure may be caused by adenoid hypertrophy and short duration of breastfeeding. Good understanding of these factors may help to decrease the recurrence rate and to improve the treatment of the disease.
authors: Department of Otolaryngology, Faculty of Medicine, Cairo University, Egypt.
authors: Mohamed
authors: M
authors: Salah
authors: Mosaad
authors: M
authors: Abdel-Aziz
authors: Ahmed
authors: A
authors: Al-Farok
authors: Azzam
authors: A
authors: Jebrini
mesh_terms: D000208:Acute Disease; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D001942:Breast Feeding / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D015994:Incidence; D007223:Infant; D008297:Male; D010033:Otitis Media / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D041361:Pacifiers / Q000009:adverse effects; D011379:Prognosis; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D012720:Severity of Illness Index; D035781:Siblings; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Acute otitis media; Adenoid; Allergy; Breastfeeding; Infantile infection; Upper respiratory infection