This invention relates to a composition comprising a bacterial strain capable of boosting the systemic immune response, a bacterial strain capable of exerting bacteriostatic effects on pathogens associated with development of otitis media such as Streptococcus pneumoniae, untypeable Haemophilus influenzae and Moraxella catarrhalis and a bacterial strain capable of exerting bacteriocidal effects on such pathogens. The invention further extends to the use of such a composition in the prevention or treatment of otitis media.