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Otitis media is very common in Aboriginal children in Western Australia and chronic ear disease causes major problems in speech and language development and education. Up until recently, most programmes dealing with the problem of OM have focused on clinical interventions rather than prevention. The Enhanced Prevention Working Group was established as part of the WA Child Ear Health Strategy (2017–2021). The Group has worked collaboratively to develop a set of recommendations for prevention of OM in Aboriginal children.

We have demonstrated that a single dose of a closely related commensal can delay onset of NTHi otitis media in vivo

The most urgent areas appear to be to continue monitoring the emergence of novel otopathogens, and the need to develop prevention and preventative therapies

Presence of bacterial otopathogen in the middle ear during ventilation tube insertion was a predictor of children at-risk of repeat ventilation tube insertion

Treatment of chronic suppurative otitis media with topical antibiotics probably results in an increase in resolution of ear discharge compared with boric acid

We are uncertain about the effectiveness of topical antibiotics in improving resolution of ear discharge in patients with chronic suppurative otitis media

Elevated antimicrobial proteins and peptides and cytokines in middle ear effusion are a marker of inflammation and bacterial persistence

Our findings are in line with a number of epidemiological studies which show a positive association between breastfeeding and OM in early childhood

Conserved vaccine candidate proteins from S.pneumoniae induce serum and salivary antibody responses in Aboriginal and non-Aboriginal children with history of OM

Identified dominant PCR-ribotypes common to geographically disparate Australian paediatric populations