How much does child day-care center attendance increases the risk of acute otitis media?

Abstract We present the case of a 13 months old infant that is visited by an acute otitis media and whose mother consults us if colds and ear infections, which his son has suffered in recent months, may be attributable to child day-care centers attendance. The following clinical question was arisen: how much does child day-care center attendance increases the risk of acute otitis media? After a literature search conducted in TRIP, the Cochrane Collaboration and MEDLINE, three systematic reviews were retrieved. The critical appraisal of these studies, although their methodological limitations that we describe, concludes that, given the adjusted risk estimators based on valid cohort studies, the risk of recurrent acute otitis media in children attended in daycare centers is approximately 50% higher than for children cared at home, which means that in the exposed population a third of the otitis could be attributable to child care center attendance. The impact of this risk in the decision of takeing the child to the child care center should be individually assessed, considering other risk factors of the patient, the social environment and the family available resources. Key words: Child day care centers, Risk factors, Otitis media.