Immunological aspects of otitis media: present views on possibilities of immunoprophylaxis of acute otitis media in infants and children.

The article reviews, based on current knowledge of immunological events affecting the middle ear, the possibilities and prospects for the prevention of otitis media (OM) by immunologic measures. While pneumococcal capsular polysaccharide vaccines proved not to be effective against infant acute otitis media (AOM), pneumococcal conjugate vaccines provide good immunogenicity even in infants, and call for trials with better prospects of clinical efficacy. The other future approaches currently under development are vaccines against nontypable Haemophilus influenzae and Branhamella catarrhalis, anti-viral immunoprophylaxis, combinations of the above alternatives, or passive immunization. Also, the use of new routes or ways of immunization are under study. Furthermore, the ways to modify the present treatment practices of AOM to favour good immunologic responses in infants and children must be studied.