Hi, Thank you for posting your query on Healthcaremagic, Coming to your query, your child is suffering from chronic otitis media with effusion. This is a condition where there is infection of middle ear (part behind ear drum) with inflammation and fluid/pus collection inside middle ear cavity. Usual modality of treatment for mild to moderate cases is to treat this infection with seven to fifteen days course of antibiotic. If this is not effective than one should try at least two different antibiotic courses. Mostly this clears infection but in few cases these courses are not quite effective. This is why because prescribed antibiotic sometime does not reach in sufficient concentration inside middle ear due to presence of pus/ effusion fluid; also there are some chemicals in pus/effusion fluid which decreases bacterial killing power of the antibiotic. Hence, in case of failure of three antibiotic courses or in those who have more than 3 episodes of acute otitis media in 6 months or 4 in a year associated with an effusion are advised for insertion of drainage tube (a grommet) inside the middle ear to effectively drain pus/effusion fluid to restore effectiveness of antibiotic and to prevent further inflammatory damage to the ear. So, to conclude my answer, I strongly recommend inserting drainage tube (a grommet) inside the middle ear with proper antibiotic coverage. This surgical procedure is a minor and safe one. So, don t worry too much about it. Following are the best practices to minimize (re-)occurrence of otitis in a child. -Vaccinate your child against the flu. Make sure your child gets the influenza, or flu, vaccine every year. -It is recommended that you vaccinate your child with the pneumococcal conjugate vaccine. Studies have shown that vaccinated children get far fewer ear infections than children who aren’t vaccinated. -Wash hands frequently. Washing hands prevents the spread of germs and can help keep your child from catching a cold or the flu. -Avoid exposing your baby to cigarette smoke. Studies have shown that babies who are around smokers have more ear infections. -Never put your baby down for a nap, or for the night, with a bottle. -Don’t allow sick children to spend time together. As much as possible, limit your child’s exposure to other children when your child or your child’s playmates are sick. Hope this will help you, take care. -Dr. Vishal Vadgama (MD)