In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media

Journal of Otolaryngology-Head & Neck Surgery

Brian D Westerberg²  William E Schreiber²  Robert Rennie³  Michael Noble⁴  Patrick Doyle⁵  LeeAnn Turnbull³  Komathi G Ayakar⁴  Veronica Restelli⁴  Inna Sekirov⁴  Anne Elizabeth Conlin¹  Jane Lea¹ 

[1] Division of Otolaryngology – Head & Neck Surgery, University of British Columbia, Vancouver, BC, Canada;St. Paul’s Hospital Rotary Hearing Clinic, Providence 2, 1081 Burrard St, Vancouver V5Y 2B8, Canada;Medical Microbiology Research Laboratory, University of Alberta Hospital, 112 Street NW, Edmonton, AB, Canada;Vancouver General Hospital, West 12th Avenue, Vancouver, BC, Canada;Department of Pathology & Laboratory Medicine, University of British Columbia, West Mall, Vancouver, BC, Canada

关键词: Staphylococcus aureus;    Pseudomonas aeruginosa;    Administration, topical;    Ciprofloxacin;    Ciprodex®;    N-acetylcysteine;    Microbial sensitivity tests;    Antibacterial agents;    Otitis media, suppurative;   

Others  :  861289
DOI  :  10.1186/1916-0216-43-20

 received in 2014-02-26, accepted in 2014-06-11,  发布年份 2014

【 摘 要 】

Background

The safety and efficacy of Ciprodex® has been demonstrated for treatment of chronic suppurative otitis media (CSOM). However, symptoms fail to resolve in 9-15% of patients. The objective of this study is to evaluate the efficacy of N-acetylcysteine (NAC) on S. aureus, and planktonic and sessile (biofilm forming) P. aeruginosa in vitro using clinical isolates from patients with CSOM.

Methods

1) Stability was assessed using liquid chromatography-mass spectrometry for each component in a prepared mixture of Ciprodex® and NAC over 15 days. Sterility was assessed by measuring bacterial growth on a blood agar plate. Efficacy was assessed using a disc diffusion method by inoculating plates with S. aureus ATCC 29513 and P. aeruginosa ATCC 27853, and measuring the clearance zone.

2) Fifteen P. aeruginosa strains were isolated from patients with CSOM and tested in vitro using the bioFILM PA™ antimicrobial susceptibility assay. Treatment solutions included Ciprodex® & ciprofloxacin +/- NAC, and NAC alone (0.25%, 0.5% & 1.25%).

Results

1) NAC combined with Ciprodex® demonstrated stability, sterility, and efficacy over a two-week period

2) P. aeruginosa strains in the sessile (33%-40%) and planktonic (13%) state demonstrated resistance to Ciprodex® and ciprofloxacin. When NAC ≥0.5% was used in isolation or as an adjunct to either of these medications, no resistance was found in the sessile or planktonic state among all 15 strains.

Conclusion

1) Ciprodex® combined with NAC has a shelf life of at least two weeks given the documented preservation of stability, sterility, and clinical efficacy of the mixed compounds.

2) P. aeruginosa strains demonstrated resistance to both Ciprodex® and ciprofloxacin. NAC ≥0.5% overcomes issues with resistance and shows promise in the treatment of CSOM.

【 授权许可】

   
2014 Lea et al.; licensee BioMed Central Ltd.

【 图 表 】

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