Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA.
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT 84113, USA.
ACS Biomater Sci Eng. 2020 Oct 12;6(10):5969-5978. doi: 10.1021/acsbiomaterials.0c01223. Epub 2020 Sep 3.
Outer ear infections (OE) affect millions of people annually with significant associated healthcare costs. Incorrect administration or non-compliance with the treatment regimen can lead to infection persistence, recurrence, antibiotic resistance, and in severe cases aggravation to malignant otitis externa. Such issues are particularly pertinent for military personnel, patients in nursing homes, the geriatric population, for patients with head or hand tremors and for those with limited or no access to proper healthcare. With the intent of using traditional material science principles to deconvolute material design while increasing relevance and efficacy, we developed a single application, cold-chain independent thixotropic drug delivery system. This can be easily applied into the ear as a liquid, then gels to deliver effective concentrations of antibiotics against bacterial strains commonly associated with OE. The system maintains thixotropic properties over several stress/no stress cycles, shows negligible swelling and temperature dependence, and does not impact the minimum inhibitory concentration or bactericidal effects of relevant antibiotics. Moreover, the thixogels are biocompatible and are well tolerated in the ear. This drug delivery system can readily translate into a user-friendly product, could improve compliance via a single application by the diagnosing health care provider, is expected to effectively treat OE and minimize the development of antibiotic resistance, infection recurrence or exacerbation.
外耳感染（OE）每年影响数百万人，相关医疗保健费用巨大。如果给药不正确或不遵守治疗方案，可能导致感染持续存在、复发、抗生素耐药，在严重情况下恶化成恶性外耳炎。对于军人、疗养院患者、老年人群、头部或手部震颤患者以及无法获得适当医疗保健的患者，这些问题尤其重要。为了使用传统材料科学原理来解决材料设计问题，同时提高相关性和有效性，我们开发了一种单一应用、冷链独立的触变药物递送系统。这种系统可以很容易地作为液体应用于耳内，然后凝胶化，以提供针对与 OE 相关的常见细菌菌株的有效抗生素浓度。该系统在多次应力/无应力循环中保持触变性，几乎没有肿胀和温度依赖性，不会影响相关抗生素的最小抑菌浓度或杀菌效果。此外，触变凝胶具有生物相容性，在耳朵中耐受良好。这种药物递送系统可以很容易转化为用户友好的产品，通过诊断保健提供者的单次应用提高依从性，有望有效治疗 OE，并最大程度地减少抗生素耐药性、感染复发或恶化的发生。
