To evaluate possible risk factors for developing recurrent acute otitis media (rAOM), 113 children were followed prospectively from birth to the age of 3 years. One of the aims was to determine whether such risk factors could be identified before the onset of the recurrences, so that optimal care and prophylactic measures could be made available at an early stage in such cases, on the basis of continuous follow-up by an ENT specialist. During the follow-up, 13 children developed rAOM, defined as six or more episodes of acute otitis media (AOM) during a 12-month period, 57 children had occasional episodes of AOM, and 43 children had no AOM at all. Of the children with onset of AOM before 6 months of age, 80% developed frequent episodes of AOM. The frequency of other respiratory tract infections and of family histories of otitis-proneness was higher among rAOM children than among the other children. The development of rAOM was unrelated to such factors as sex, familial history of allergy, duration of breast-feeding, or domestic environment. Nor could attendance at day-care centres be concluded as constituting a risk factor for the development of rAOM. An onset of AOM before 6 months of age was highly predictive of subsequent recurrent bouts of AOM, which emphasizes the importance of correct diagnosis in infants.

Long-term, low-dose erythromycin therapy seems to be a promising alternative when more conventional therapy fails. However, placebo-controlled studies are needed to validate the potential of this treatment.

Monoclonal antibodies and flow cytometry are now used routinely in the diagnosis of many malignant diseases and primary and secondary immunodeficiency states. Technical advances have improved the identification of blood lymphocyte subsets and reliable normal values are now obtainable. Such values have been reported for adults but not for children. We report both absolute and percentage normal values for lymphocytes and their subsets in infants and children of different ages. Our findings show that the absolute and percentage values for most lymphocyte markers differ substantially not only between children and adults, but also between children from different age groups. In infants, erythroid cell contamination of Ficoll gradient-density isolated mononuclear cells must be removed to obtain reliable flow cytometry values.

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