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In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media
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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4094889/ https://www.ncbi.nlm.nih.gov/pubmed/25001062 http://dx.doi.org/10.1186/1916-0216-43-20 |
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author | Lea, Jane Conlin, Anne Elizabeth Sekirov, Inna Restelli, Veronica Ayakar, Komathi G Turnbull, LeeAnn Doyle, Patrick Noble, Michael Rennie, Robert Schreiber, William E Westerberg, Brian D |
author_facet | Lea, Jane Conlin, Anne Elizabeth Sekirov, Inna Restelli, Veronica Ayakar, Komathi G Turnbull, LeeAnn Doyle, Patrick Noble, Michael Rennie, Robert Schreiber, William E Westerberg, Brian D |
author_sort | Lea, Jane |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4094889 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40948892014-07-15 In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media Lea, Jane Conlin, Anne Elizabeth Sekirov, Inna Restelli, Veronica Ayakar, Komathi G Turnbull, LeeAnn Doyle, Patrick Noble, Michael Rennie, Robert Schreiber, William E Westerberg, Brian D J Otolaryngol Head Neck Surg Original Research Article 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. BioMed Central 2014-07-07 /pmc/articles/PMC4094889/ /pubmed/25001062 http://dx.doi.org/10.1186/1916-0216-43-20 Text en Copyright © 2014 Lea et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Article Lea, Jane Conlin, Anne Elizabeth Sekirov, Inna Restelli, Veronica Ayakar, Komathi G Turnbull, LeeAnn Doyle, Patrick Noble, Michael Rennie, Robert Schreiber, William E Westerberg, Brian D In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title | In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title_full | In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title_fullStr | In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title_full_unstemmed | In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title_short | In vitro efficacy of N-acetylcysteine on bacteria associated with chronic suppurative otitis media |
title_sort | in vitro efficacy of n-acetylcysteine on bacteria associated with chronic suppurative otitis media |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4094889/ https://www.ncbi.nlm.nih.gov/pubmed/25001062 http://dx.doi.org/10.1186/1916-0216-43-20 |
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