[Recurrent upper respiratory tract infections and otitis in children]

Recurrent upper respiratory tract infections should be considered as a normal process in infants who build immune defenses in an environment where they meet viruses. Nasal lavage with saline serum and the blowing when possible are the only treatment justified in all the cases. Antibiotic treatment is not justified. It does not shorten the course and does not prevent complications. Recurrent otitis media (three episodes in six months or four in one year) are the most common complication. Bacterial superinfections are due to bacteria who colonise nasopharynx. Facilitating factors for recurrent ENT infections in children are individual: age, sex, martial deficiency, gastro-oesophageal reflux, adenoid growths. Other facilitating factors are environmental: absence or short duration of breast-feading, pollution, passive smoking, day care center. In the great majority of cases, laboratory tests are unnecessary. The most important is to reassure because recurrent upper respiratory infections improve with time. Different facilitating factors previously described have to be taken into account and should allow to decrease the number of episodes.