Mastoiditis primary prevention

Preventing mastoiditis primarily involves preventing development of otitis media and nasopharyngitis. This is achieved by administration of the pneumococcal and influenza vaccines, frequent washing of hands, and avoiding fluid transmission and respiratory droplets from nasopharyngitis patients. Preventing exposure to air pollution and potential middle ear irritants, such as secondhand smoke, helps prevent otitis media. For infants, preventive measures include avoiding pacifiers, avoiding daycare enrollment, and breastfeeding until at least 6 months of age. A prophylactic regimen of antibiotics can prevent otitis media in at-risk infants and children.

Preventive measures for mastoiditis such as the following involve preventing the development of otitis media and nasopharyngitis from infectious pathogens:

• Administer the following vaccinations:^[1]
  • Pneumococcal
  • Influenza
• Wash hands frequently
• Avoid coughing and respiratory droplets from patients with respiratory illness and nasopharyngitis.

• Avoid first or secondhand smoke or other air pollutants with potential for middle ear irritation.^[2]
• Avoid use of pacifiers in infants.
• Avoid enrollment in daycare centers.
• Breastfeed infants until at least 6 months of age^[3]
  • This is correlated with higher levels of antibodies to acute otitis media causative agent nontypeable Haemophilus influenzae, as well as pathogenic outer membrane protein P6

Administering a prophylactic antibiotic regimen for children at risk of developing recurrent otitis media (such as immunosuppressed children or the genetically susceptible):

• Preferred regimen (1): Amoxicillin 20 mg/kg po once daily.^[4]
• Preferred regimen (2): Sulfisoxazole 50 mg/kg po at bedtime.^[4]
• Alternative Regimen (1): TMP-SMX 4 mg-20 mg/kg once daily.^[4]

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