How common is recurrent acute otitis media?

To illustrate how the number of children with recurrent acute otitis media (RAOM) and the natural history of this condition vary according to the criterion used, different criteria were tested in a random sample of 2,411 children monitored for otitis media up to an average age of 22 months. The numbers of children fulfilling the criteria of at least 2, 3 and 4 episodes in 6 months were calculated and the natural history of otitis media during the following 6 months was examined among the children who had had a sufficient follow-up time and who had received no special prophylaxis. At least 2, 3 or 4 episodes in 6 months were experienced by 825 (34%), 375 (15%) and 118 (5%) children, respectively. During the 6 subsequent months after contracting the second, third or fourth episode, 5, 4 and 5% of the infants developed chronic otitis media with effusion and an additional 10, 12 and 7% respectively, continued to have recurrent episodes without any special prophylaxis. In all, the proportion of children with recurrent episodes varied according to the criterion used. RAOM seemed to be a temporal phenomenon, however, and spontaneous recovery without any special prophylaxis was common with increasing age irrespective of the criterion used.