Secondary prevention

The following actions may help prevent ear infections: breastfeeding during infancy, avoiding exposure to tobacco smoke, feeding the child with the head elevated and avoiding pacifiers when possible, and avoiding settings that increase a child’s exposure to cold viruses.[15][60]​​[61]

The pneumococcal conjugate vaccine may have a modest effect on the incidence of AOM, particularly against vaccine strains of pneumococcus.[62][63][64]​ Research on the influenza virus immunization for the prevention of AOM has been inconclusive.[65] [ Cochrane Clinical Answers logo ] [Evidence B]

Treatment of influenza infections with oseltamivir may prevent middle ear involvement and thus decrease the occurrence of AOM during influenza season.[66][67]

The use of xylitol, a sugar alcohol, as either a syrup or a gum for the prevention of AOM has produced mixed results.[68][69][70][71] [ Cochrane Clinical Answers logo ]

The use of antibiotics for the prevention of AOM, although of limited benefit (the number needed-to-treat to prevent 1 person from experiencing an infection is 5), will likely lead to selection of resistant bacteria.[72] [ Cochrane Clinical Answers logo ]

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