Otitis media is an infection of the middle ear (behind the eardrum) that causes swelling, pain, fever, and discharge. While it can affect all ages, it is most common in children aged 6 to 36 months.

Children are more prone to otitis media than adults due to their shorter, more horizontal eustachian tubes. This anatomical difference allows secretions from the nose and throat to easily accumulate and spread to the ear instead of draining normally into the throat. This creates an environment for bacteria and viruses from the nose and throat to enter the middle ear, causing inflammation.

A child's developing immune system has a weaker ability to fight off bacteria and viruses, increasing the risk of upper respiratory infections. After an acute episode of otitis media, fluid may persist in the middle ear even if symptoms subside. If a child contracts a new infection, the risk of recurrent otitis media is high.

Children attending school are exposed to many peers in enclosed spaces, increasing the likelihood of cross-infection with upper respiratory illnesses such as colds and pharyngitis. Each respiratory infection provides an opportunity for bacteria and viruses to attack.

In young children, adenoids (VA) are often large and prone to infection. Enlarged or chronically inflamed adenoids can compress and obstruct the eustachian tube's drainage function, leading to fluid buildup—a factor contributing to recurrent otitis media.

Dr. Nguyen consulting a parent. Photo: Tam Anh General Clinic, District 7.

Antibiotics only treat acute bacterial infections; they do not reduce enlarged adenoids, respiratory allergies, or affect the eustachian tube's anatomical structure. This is why your child's condition remains prone to recurrence despite antibiotic use. Additionally, not completing the full course of antibiotics prescribed by a doctor means bacteria may not be entirely eliminated, leading to early reinfection.

Frequent, untreated recurrent ear infections increase the risk of chronic otitis media. Chronic otitis media is more challenging to treat and can lead to complications such as hearing loss, impaired hearing, delayed speech, developmental delays, and communication difficulties.

To limit recurrence, parents should strictly follow the prescribed duration and dosage of antibiotics, avoid discontinuing medication prematurely, and attend follow-up appointments for a doctor's assessment. Parents must ensure the child avoids secondhand smoke, limit bottle feeding or drinking while lying on their back, ensure complete vaccination, and maintain daily nasal and throat hygiene. Proper nasal cleaning when the child has a runny nose prevents fluid buildup that can prolong the illness.

Dr. Tran Xuan Nguyen, First Degree Specialist

Ear, Nose, Throat Specialist

Tam Anh General Clinic, District 7