Aim: This study aimed to evaluate the effectiveness of a pharmacological intervention in reducing the incidence of otitis media, improving hearing outcomes, and minimizing antibiotic usage in children in a community-based setting. Material and Methods: This prospective, community-based, interventional study included 200 children aged 6 months to 12 years from urban and semi-urban regions. Participants were selected based on recurrent otitis media history, and pharmacological intervention included prophylactic antibiotics or immunomodulators administered over six months with monthly follow-ups. Baseline assessments included medical history, ENT examinations, audiometric tests, and detailed parental education on adherence and symptom recognition. Outcomes measured included a reduction in otitis media episodes, improvements in hearing thresholds, antibiotic dependency, and adverse effects. Results: The intervention resulted in a significant reduction in the frequency of otitis media episodes (4.2 ± 1.5 to 1.3 ± 0.8, p<0.001) and improved hearing thresholds (35.5 ± 5.8 dB to 25.3 ± 4.5 dB, p<0.001). Antibiotic usage also decreased significantly (77.5% to 22.5%, p<0.001). Adverse effects were minimal, with mild gastrointestinal upset (7.5%), skin rash (4.0%), and fatigue (2.5%). Parental adherence was high, with 89% showing consistent compliance. Conclusion: Pharmacological intervention effectively reduced otitis media episodes, improved hearing outcomes, and decreased antibiotic dependency with minimal adverse effects. High parental adherence further contributed to successful outcomes, underscoring the intervention's effectiveness and feasibility in community-based settings.