Primary prevention

Upper respiratory tract infection may be a frequent precipitating factor for OME (and acute otitis media [AOM]).[2] Mucosal inflammation secondary to infection can lead to obstruction and dysfunction of the Eustachian tubes, thereby leading to fluid accumulation within the middle ear.[11] Prevention of upper respiratory tract infections may therefore prevent OME (and AOM).

The pneumococcal conjugate and influenza vaccines are recommended to prevent pneumococcal- and influenza-related illnesses, which may in turn prevent AOM and as such, secondary OME.[42][43][44][45][46] Details on current vaccination schedules and special patient populations can be found in the latest CDC Advisory Committee on Immunization Practices (ACIP) vaccination schedule. CDC: ACIP recommendations Opens in new window

Avoidance of tobacco smoke exposure may also decrease the risk of OME. One meta-analysis found that second-hand smoke exposure was significantly associated with increased odds of middle ear disease, although the heterogeneity among the included studies was high.[47]​ In adults, an association was found between tobacco smoking and chronic suppurative otitis media, with mixed evidence.[48][49]​​​

Daycare attendance is a risk factor for recurrent AOM and OME.[33][10] This is likely related to increased exposure to viral pathogens, which cause upper respiratory tract infections. If feasible for the family, taking a child out of daycare may prevent both AOM and OME.

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