Otitis media (OM; middle ear infection) is the most common reason for pre-school children to visit a doctor, be prescribed antimicrobials, or undergo surgery. Recent Cochrane reviews of clinical trials have identified that antibiotics and grommet surgery are only moderately effective in treating OM, with recurrent or persistent infection observed in one-third of children. Research efforts are focusing on developing improved therapies to treat OM and prevent disease recurrence. The recurrent nature of OM is mostly due to the persistence of bacterial pathogens within established biofilm in the middle ear. Promising novel therapies are harnessing host-microbe interactions to disrupt middle ear biofilm and permit antibiotics to work more effectively. New approaches are also being developed to prevent OM, including new vaccines and mining the host respiratory microbiome to develop novel bacterial therapies. This review describes how our improved knowledge of human and microbial interactions is driving development of OM therapies to improve health outcomes for children in Australia and worldwide.

中耳炎（OM；中耳感染）是学龄前儿童去看医生，开处方抗菌药物或进行手术的最常见原因。近期Cochrane对临床试验的评论表明，抗生素和索环手术仅在OM中有效，在三分之一的儿童中观察到复发或持续感染。研究工作集中在开发改进的疗法来治疗OM和预防疾病复发。OM的复发性主要是由于中耳已建立的生物膜内细菌病原体的持续存在。有希望的新疗法正在利用宿主与微生物之间的相互作用来破坏中耳生物膜，并使抗生素更有效地发挥作用。还正在开发新的方法来预防OM，包括新疫苗和挖掘宿主呼吸微生物组以开发新的细菌疗法。这篇评论描述了我们对人与微生物相互作用的了解如何推动OM治疗的发展，以改善澳大利亚和全球儿童的健康状况。