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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

Peter Ruth Elke Richmond Thornton Seppanen MBBS MRCP(UK) FRACP PhD BSc PhD Head, Vaccine Trials Group Co-head, Bacterial Respiratory Infectious

Ruth Elke Peter Thornton Seppanen Richmond PhD BSc PhD MBBS MRCP(UK) FRACP Co-head, Bacterial Respiratory Infectious Disease Group (BRIDG) Program

Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. The predominant symptoms of CSOM are ear discharge and hearing loss. Systemic antibiotics are commonly used to treat people with CSOM. This is the first update to the review published in 2021, and is one of a suite of seven Cochrane reviews evaluating the effects of non-surgical interventions for CSOM.