Controlled release of ciprofloxacin and ceftriaxone from a single ototopical administration of antibiotic-loaded polymer microspheres and thermoresponsive gel

In vivo biodistribution and ototoxicity assessment of cationic liposomal-ceftriaxone via noninvasive trans-tympanic delivery in chinchilla models: Implications for otitis media therapy

OBJECTIVES

We report the in vivo biodistribution and ototoxicity of cationic liposomal-ceftriaxone (CFX) delivered via ear drop formulation in adult chinchilla.

METHODS

CFX was encapsulated in liposomes with size of ∼100 nm and surface charge of +20 mV. 100 μl liposomes or free drug was applied twice daily in both external ear canals of adult chinchillas for either 3 or 10 days. Study groups included free ceftriaxone (CFX, Day 3: n = 4, Day 10: n = 8), liposomal ceftriaxone (CFX-Lipo, Day 3: n = 4, Day 10: n = 8), and a systemic control group (Day 3: n = 4, Day 10: n = 4). Ceftriaxone delivery to the middle ear and systemic circulation was quantified by HPLC assays. Liposome transport was visualized via confocal microscopy. Auditory brainstem response (ABR) tests and cochlear histology were used to assess ototoxicity.

RESULTS

Liposomal ceftriaxone (CFX-Lipo) displayed a ∼658-fold increase in drug delivery efficiency in the middle ear relative to the free CFX (8.548 ± 0.4638% vs. 0.013 ± 0.0009%, %Injected dose, Mean ± SEM). CFX measured in blood serum (48.2 ± 7.78 ng/ml) following CFX-Lipo treatment in ear was 41-fold lower compared to systemic free-CFX treatment (1990.7 ± 617.34 ng/ml). ABR tests and histological analysis indicated no ototoxicity due to the treatment.

CONCLUSION

Cationic liposomal encapsulation results in potent drug delivery across the tympanic membrane to the middle ear with minimal systemic exposure and no ototoxicity.

Glycerospanlastics: State-of-the-art two-in-one nano-vesicles for boosting ear drug delivery in otitis media treatment

The purpose of this research was to design innovative nanovesicles for ototopical conveyance of triamcinolone acetonide (TA) for otitis media (OM) treatment via incorporating glycerol into nanospanlastics to be termed "Glycerospanlastics". The glycerospanlastics were formulated employing ethanol injection procedure, and central composite design (CCD) was harnessed for optimization of the vesicles. Various attributes of the nanovesicles, viz. particle size distribution, surface charge, TA entrapment efficiency, morphology as well as ex-vivo permeation across the tympanic membrane (TM) were characterized. In vivo implementation of the optimized glycerospanlastics loaded with TA was appraised in OM-induced rats via histopathological and biochemical measurements of the tumor necrosis factor-α (TNF-α) and Interleukin-1β (IL-1β) levels in ear homogenates. The safety and tolerability of optimized TA glycerospanlastics was also investigated in non-OM induced animals. The results demonstrated that the optimized TA-glycerospanlastics were in a nanometer range (around 200 nm) with negative charges, high TA entrapment (>85%), good storage properties and better TM permeation relative to TA suspension. More importantly, TA-glycerospanlastics performed better than marketed drug suspension in OM treatment as manifested by restoration of histopathological alterations in TM and lowered values of IL-1β and TNF-α. Glycerospanlastics could be promising safe ototopical nanoplatforms for OM treatment and other middle ear disorders.

Topical Delivery of Elastic Liposomal Vesicles for Treatment of Middle and Inner Ear Diseases

We present a topical drug delivery mechanism through the ear canal to the middle and inner ear using liposomal nanoparticles without disrupting the integrity of the tympanic membrane. The current delivery method provides a noninvasive and safer alternative to transtympanic membrane injections, ear tubes followed by ear drops administration, and systemic drug formulations. We investigate the capability of liposomal NPs, particularly transfersomes (TLipo), used as drug delivery vesicles to penetrate the tympanic membrane (TM) and round window membrane (RWM) with high affinity, specificity, and retention time. The TLipo is applied to the ear canal and found to pass through the tympanic membrane quickly in 3 h post drug administration. They are identified in the middle ear cavity 6 h and in the inner ear 24 h after drug administration. We performed cytotoxicity in vitro and ototoxicity in vivo studies. Cell viability shows no significant difference between the applied TLipo concentration and control. Furthermore, auditory brainstem response (ABR) reveals no hearing loss in 1 week and 1 month post-administration. Immunohistochemistry results demonstrate no evidence of hair cell loss in the cochlea at 1 month following TLipo administration. Together, the data suggested that TLipo can be used as a vehicle for topical drug delivery to the middle ear and inner ear.

Thermoresponsive and antibacterial two-dimensional polyglycerol-interlocked-polynipam for targeted drug delivery

Two-dimensional polymeric networks are a new class of polymers with interesting physicochemical and biological properties. They promise a wide range of future biomedical applications including pathogen interactions, drug delivery, bioimaging, photothermal, and photodynamic therapy, owing to their unique features, such as high surface area and multivalent interactions at nano-biointerfaces. In this work, a thermosensitive two-dimensional polymeric network consisting poly(N-isopropylacrylamide) (pNIPAM) chains that are mechanically interlocked by a polyglycerol platform was synthesized and used for bacteria incapacitation. Two-dimensional hyperbranched polyglycerol (2D-hPG) was synthesized by a graphene-assisted strategy and used for encapsulation of azobisisobutyronitrile (AIBN). Radical polymerization of N-isopropylacrylamide by encapsulated AIBN resulted in thermoresponsive platforms with ~ 500 nm lateral size and 20-50 nm thickness. Due to its porous structure, 2D-PNPG was able to efficiently load antibiotics, such as tetracycline (TC) and amoxicillin (AMX). The rate of release of antibiotics from 2D-PNPG and the antibacterial activity of the system correlated with the variation of temperature as a result of the thermosensitivity of 2D-PNPG. This study shows that two-dimensional polymers are efficient platforms for future biomedical applications including drug delivery and bacteria incapacitation.

Graphical abstract

Thermoresponsive two-dimensional nanomaterials with the ability of loading therapeutic agents and antibacterial activity are synthesized and characterized.

Polyurethane based hybrid ciprofloxacin-releasing wound dressings designed for skin engineering purpose

PURPOSE

Even in the 21st century, chronic wounds still pose a major challenge due to potentially inappropriate treatment options, so the latest wound dressings are hybrid systems that enable clinical management, such as a hybrid of hydrogels, antibiotics and polymers. These wound dressings are mainly used for chronic and complex wounds, which can easily be infected by bacteria.

MATERIALS AND METHODS

Six Composite Porous Matrices (CPMs) based on polyurethane (PUR) in alliance with polylactide (PLAs) and poly(vinyl alcohol) (PVA) were prepared and analyzed using optical microscopy. Three different types of hydrogels and their Ciprofloxacin (Cipro) modified variants' ratios were prepared and analyzed using FTIR, SEM and EDX techniques. Six Hybrid Cipro-Releasing Hydrogel Wound Dressings (H-CRWDs) were also prepared and underwent short-term degradation, Cipro release, microbiology and cell viability measurements.

RESULTS

Average porosity of CPMs was in the range of 69-81%. The pore size of the obtained CPMs was optimal for skin regeneration. Short-term degradation studies revealed degradability in physiological conditions regardless of sample type. A meaningful release was also observed even in short time (21.76 ​± ​0.64 ​μg/mL after 15 ​min). Microbiological tests showed visible inhibition zones. Cell viability tests proved that the obtained H-CRWDs were biocompatible (over 85% of cells).

CONCLUSIONS

A promising hybrid wound dressing was labeled. Simple and cost-effective methods were used to obtain microbiologically active and biocompatible dressings. The results were of importance for the design and development of acceptable solutions in the management of chronic wounds of high potential for infection.

From Evidence to Clinical Guidelines in Antibiotic Treatment in Acute Otitis Media in Children

Acute otitis media (AOM) in children represents a public health concern, being one of the leading causes of health care visits and antibiotic prescriptions worldwide. The overall aim of this paper is to unravel the major current insights into the antibiotic treatment of AOM in children. Our approach is three-fold: 1. a preclinical evaluation of antibiotics in animal models of AOM stressing on the advantages of different species when testing for different schemes of antibiotics; 2. an overview on the new antimicrobial agents whose efficacy has been demonstrated in refractory cases of AOM in children; and 3. an analysis of the different guidelines stressing on the differences and similarities between the various schemes of antibiotic treatment. The preferred therapeutic agents remain amoxicillin and the amoxicillin-clavulanate combination for AOM caused by Streptococcus pneumoniae, whereas oral cephalosporin is preferred in AOM due to Moraxella catarrhalis and Haemophilus influenzae. As for the second and third line antimicrobial treatments, there is a wide variety of suggested antibiotic classes with variations in duration and posology. The decision to prescribe antimicrobial treatment as a first-line choice is based on the severity of the symptoms in 16 of the guidelines included in this review.