Recent studies have reported that resistance to clinically relevant antibiotics is high in bacterial isolates from middle ear infections (acute otitis media – AOM) and continuing to rise. Thus, there is a critical need to develop new non-antibiotic, non-invasive treatments for AOM. If antibiotic resistance continues to rise in AOM pathogens, this will remove one of the frontline weapons that clinicians possess to treat AOM and could potentially lead to a global increase rates of hearing loss and damage. The long-term goal of our lab is to examine interactions between bacterial pathogens and their hosts and create new therapeutic options for the treatment of pathogens. One potential non-antibiotic avenue is use of high energy visible light (HEV), which is in the blue light spectrum (not UV) and commonly used in dermatological applications. Our group has shown that HEV light is highly effective at killing the three major AOM pathogens in vitro in as little as 15-30 minutes. Therefore, the objective of the proposed work is to develop a prototype for high energy visible light administration in the form of a wearable, hearing aid-like device that emits HEV light into the ear canal to treat AOM without damaging the surrounding eukaryotic cells and tissue. To achieve this objective, our group will (1) identify the optimal variables of HEV light treatments for the treatment of AOM pathogens; (2) define the risks of HEV light treatments on eukaryotic tissues and cells; (3) use this information to establish an effective prototype for HEV light administration in the form of a wearable, hearing aid-like device. Currently, the dogma for reducing antibiotic resistance is for clinicians to be more judicious with antibiotic prescriptions and to generate new antibiotics. By contrast, our innovation that uses precise delivery of HEV light provides an effective, non-antibiotic, and non-surgical method to treat middle ear infections. The proposed research is significant as it could positively affect the millions of people afflicted with chronic or recurrent infections and give clinicians an alternative to antibiotics for AOM that will not contribute to antibiotic resistance. Ultimately, the administration of HEV light to kill ear pathogens, in the form of a wearable device, has the potential to change the clinical paradigm for a AOM treatment.