Mucociliary clearance is a first line of defence against airway infection. Motile cilia function is important for the transport of inhaled bacteria and other unwanted particulate matter away from the lungs. Primary ciliary dyskinesia (PCD) is an inherited condition in which motile cilia function is disrupted. Patients with PCD suffer from poor mucociliary clearance of the upper and lower airways leading to chronic wet cough, rhinusinusitis, otitis media and reoccurring infections [1]. The most commonly isolated organism from PCD sputum or nasal lavage is Haemophilus influenzae [1]. Non-typeable Haemophilus influenzae (NTHi) have been shown to form biofilms in the adenoids and middle ear of children with otitis media [2, 3]. The study by Walker et al. [4] in this issue of the European Respiratory Journal poses the question: is the respiratory epithelium in PCD susceptible to NTHi biofilms due to motile ciliary dysfunction?