以下行为可能有助于防止耳部进一步感染:避免接触二手烟、喂养孩子时头部垫高、尽量避免使用仿真奶嘴、避免接触可增加孩子接触到感冒病毒的环境。
肺炎球菌结合疫苗对急性中耳炎的发病率有一定影响,尤其是对肺炎球菌疫苗株。[44]Eskola J, Kilpi T, Palmu A, et al. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med. 2001;344:403-409.http://www.ncbi.nlm.nih.gov/pubmed/11172176?tool=bestpractice.com[45]Kyaw MH, Lynfield R, Schaffner W, et al. Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. N Engl J Med. 2006;354:1455-1463.http://www.ncbi.nlm.nih.gov/pubmed/16598044?tool=bestpractice.com[46]Pavia M, Bianco A, Nobile CG, et al. Efficacy of pneumococcal vaccination in children younger than 24 months: a meta-analysis. Pediatrics. 2009;123:e1103-e1110.http://www.ncbi.nlm.nih.gov/pubmed/19482744?tool=bestpractice.com[47]Fortanier AC, Venekamp RP, Boonacker CW, et al. Pneumococcal conjugate vaccines for preventing otitis media. Cochrane Database Syst Rev. 2014;(4):CD001480.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001480.pub4/fullhttp://www.ncbi.nlm.nih.gov/pubmed/24696098?tool=bestpractice.com有关流感病毒免疫接种对预防急性中耳炎的研究一直没有定论。[48]Clements DA, Langdon L, Bland C, et al. Influenza: a vaccine decreases the incidence of otitis media in 6- to 30-month-old children in day care. Arch Pediatr Adolesc Med. 1995;149:1113-1117.http://www.ncbi.nlm.nih.gov/pubmed/7550814?tool=bestpractice.com[49]Belshe RB, Mendelman PM, Treanor J, et al. The efficacy of live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine in children. N Engl J Med. 1998;338:1405-1412.http://www.ncbi.nlm.nih.gov/pubmed/9580647?tool=bestpractice.com[50]Belshe RB, Gruber WC. Prevention of otitis media in children with live attenuated influenza vaccine given intranasally. Pediatr Infect Dis J. 2000;19(5 Suppl):S66-S71.http://www.ncbi.nlm.nih.gov/pubmed/10821474?tool=bestpractice.com[51]Hoberman A, Greenberg DP, Paradise JL, et al. Effectiveness of inactivated influenza vaccine in preventing acute otitis media in young children: a randomized controlled trial. JAMA. 2003;290:1608-1616.http://www.ncbi.nlm.nih.gov/pubmed/14506120?tool=bestpractice.com[52]Jansen AG, Sanders EA, Hoes AW, et al. Effects of influenza plus pneumococcal conjugate vaccination versus influenza vaccination alone in preventing respiratory tract infections in children: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2008;153:764-770.http://www.ncbi.nlm.nih.gov/pubmed/18621393?tool=bestpractice.com
采用奥司他韦治疗流感感染可预防中耳感染,因此,它可降低流感季节急性中耳炎的发病率。[53]Winther BB. Impact of oseltamivir treatment on the incidence and course of acute otitis media in children with influenza. Int J Pediatr Otorhinolaryngol. 2010;74:684-688.http://www.ncbi.nlm.nih.gov/pubmed/20363510?tool=bestpractice.com[54]Hayden FG. Influenza virus and rhinovirus-related otitis media: potential for antiviral intervention. Vaccine. 2000;19(Suppl 1):S66-S70.http://www.ncbi.nlm.nih.gov/pubmed/11163466?tool=bestpractice.com[55]Gibbs D. Oseltamivir effective for reducing influenza duration in children. Am Fam Physician. 2010;82:1140-1141.http://www.aafp.org/afp/2010/1101/p1140.html
使用木糖醇(一种糖醇),无论是作为糖浆还是口香糖来预防急性中耳炎均已产生不同的效果。[56]Tapiainen T, Luotonen L, Kontiokari T, et al. Xylitol administered only during respiratory infections failed to prevent acute otitis media. Pediatrics. 2002;109:E19.http://pediatrics.aappublications.org/cgi/content/full/109/2/e19http://www.ncbi.nlm.nih.gov/pubmed/11826229?tool=bestpractice.com[57]Hautalahti O, Renko M, Tapiainen T, et al. Failure of xylitol given three times a day for preventing acute otitis media. Pediatr Infect Dis J. 2007;26:423-427.http://www.ncbi.nlm.nih.gov/pubmed/17468653?tool=bestpractice.com[58]Lagace E. Xylitol for prevention of acute otitis media. J Fam Pract. 1999;48:89.http://www.ncbi.nlm.nih.gov/pubmed/10037531?tool=bestpractice.com[59]Azarpazhooh A, Lawrence HP, Shah PS, et al. Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database Syst Rev. 2016;(8):CD007095.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007095.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/27486835?tool=bestpractice.com[60]Danhauer JL, Johnson CE, Corbin NE, et al. Xylitol as a prophylaxis for acute otitis media: systematic review. Int J Audiol. 2010;49:754-761.http://www.ncbi.nlm.nih.gov/pubmed/20874048?tool=bestpractice.com [
]In children up to 12 years of age, what are the benefits and harms of xylitol for preventing acute otitis media?https://cochranelibrary.com/cca/doi/10.1002/cca.1487/full显示答案
使用抗生素预防急性中耳炎受益有限(在需要治疗的人中,5 人中仅可预防 1 人感染),但可能选择了耐药性细菌。[61]Leach AJ, Morris PS. Antibiotics for the prevention of acute and chronic suppurative otitis media in children. Cochrane Database Syst Rev. 2006;(4):CD004401.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004401.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17054203?tool=bestpractice.com [
]In children at high risk of acute and chronic suppurative otitis media, is there randomized controlled trial evidence to support the use of antibiotic prophylaxis?https://cochranelibrary.com/cca/doi/10.1002/cca.94/full显示答案