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Otitis media (OM) starts within weeks of birth in almost all Indigenous infants living in remote areas of the Northern Territory (NT).

To assess the effectiveness of antibiotics versus antiseptics for people with chronic suppurative otitis media.

To assess the effects of topical antiseptics for people with chronic suppurative otitis media

To assess the effects of systemic antibiotics for people with chronic suppurative otitis media.

To assess the effects of topical antibiotics for people with chronic suppurative otitis media.

To assess the effects of adding a topical steroid to topical antibiotics in the treatment of people with chronic suppurative otitis media

These data provide evidence that otitis-prone children do not have impaired functional cell mediated immunity

This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition

The production of functional antipneumococcal antibodies in otitisprone children demonstrates that they respond to the current pneumococcal conjugate vaccine (PCV)and are likely to respond to pneumolysin-based vaccines as effectively as healthy children.

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