New prospects in the prevention of otitis media.

Otitis media is the most common bacterial infection in children, accounting for a substantial economic burden to the health care system. Together with concern for long-term developmental sequelae, prevention of otitis media has become a high priority area of research. A wide range of factors has been associated with an increased risk of acute otitis media. Most of these factors, however, predispose to upper respiratory tract infection which, in turn, can be considered the most important risk factor for acute otitis media. Conventionally, antimicrobial prophylaxis, tympanostomy tubes and adenoidectomy have been used for prevention of otitis media. At present, the vaccine approach seems to hold the greatest promise for ultimate prevention of otitis media. In addition to the bacterial vaccines, vaccines against the most common viruses predisposing to acute otitis media may also prove valuable in the prevention of otitis media.