Epidemiology and etiology

Otitis media is most common in children between 6 months and 2 years of age but can occur in all age groups, including adults. By age 3 years, up to 85% of children have had at least one episode of otitis media, and up to 20% have recurrent infections by age 12 months. At least 13 million antibiotic prescriptions are written annually in the United States for otitis media, resulting in $2 billion in direct costs.4 Many risk factors (Table 72-1) predispose children to otitis media and can be associated with microbi-al resistance, such as daycare attendance, prior antibiotic exposure, and age younger than 2 years.3,5,6

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