Dual red and near-infrared LED therapy inhibits MRSA biofilm in otitis media.

Otitis media (OM), particularly when caused by methicillin-resistant (MRSA), can become refractory due to biofilm formation, which contributes to resistance against conventional antimicrobial treatments. Photobiomodulation using light-emitting diode (LED) therapy has recently emerged as a promising non-antibiotic strategy for managing refractory infections by targeting biofilm-associated pathology. However, especially in the context of MRSA-induced OM, its therapeutic efficacy and underlying mechanisms remain incompletely elucidated. In this study, we established a rat model of OM by inoculating MRSA (5 × 10 CFUs) into the middle ear via the tympanic membrane. Red and near-infrared (NIR) LED irradiation (655/842 nm; 163.2 W/m; 30 min/day for 5 days) was administered 1 week after infection. Scanning electron microscopy revealed a marked reduction in MRSA biofilm structures, and biofilm biomass was significantly decreased, as assessed by crystal violet staining. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis demonstrated significant downregulation of , , , and , key genes crucial for bacterial adhesion and biofilm development. Histological assessment further showed decreased mucosal thickening and macrophage infiltration, supported by reduced ionized calcium-binding adapter molecule 1 (Iba1) expression. These findings suggest that dual red and NIR LED therapy effectively suppresses MRSA biofilm formation and inflammation in OM, indicating its potential as a novel non-antibiotic therapy for biofilm-associated OM that may help manage persistent or treatment-resistant cases in clinical settings.