Otitis media (OM) is one of the most common conditions encountered by clinicians who deliver health care to children. From 1986 to 1987 alone, 31 million physician of ce visits in the United States were related to OM, with an estimated annual cost of at least $3.5 billion (1). Klein (2), citing a survey conducted by the Centers for Disease Control and Prevention (CDC), also noted the high occur-
visits in 1990. Moreover, in a recent report that analyzed data for both 1981 and 1988, Lanphear and colleagues (3) asserted that the prevalence of recurrent OM increased.