Xylitol is a sweetener that has been found to reduce bacterial counts in the nose and airways. Oral xylitol in a daily dose of 8.4-10 grams, given in five divided doses, was found to reduce the incidence of acute otitis media (AOM) by 35-40% in young children. The need for antimicrobials decreased markedly when using xylitol. Although xylitol is a very promising novel agent in the prevention of AOM, several studies concluded that a more practical dosage schedule is needed before its use can be widely recommended. One possible alternative would be to deliver a total daily dose similar to that which has previously been shown effective, but divided into fewer doses per day. Oral xylitol solution at higher dosages was found to be well-tolerated. Gastrointestional side effects (gas; diarrhea) were found to be more prevalent among children aged 9 months and younger. Our compounding professionals can prepare xylitol as a concentrated syrup, oral gel, or lollipop, flavored and colored according to each child’s preference. We can also compound xylitol nasal spray. Your questions are welcome.