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  • Title: Effect of ototopical medications on tympanostomy tube biofilms.
    Author: Oxley KS, Thomas JG, Ramadan HH.
    Journal: Laryngoscope; 2007 Oct; 117(10):1819-24. PubMed ID: 17690613.
    Abstract:
    OBJECTIVE: Examine how ototopical medications affect biofilms on fluoroplastic tympanostomy tubes. STUDY DESIGN: In vitro comparison of different ototopical medications against a clinical isolate of Pseudomonas aeruginosa biofilm on tympanostomy tubes treated for 5, 10, 14, and 21 days. METHODS: Under sterile conditions 21 tympanostomy tubes were cut in half. These were attached to pegs of two Calgary Biofilm Devices via rubber cement. Device 1 evaluated microbial growth as colony forming units (CFUs). Device 2 evaluated presence of biofilms. Tubes were prepped for biofilm growth, incubated, and stressed for 72 hours. Afterward, one tube per device was removed and forcefully washed. One was sonificated for 5 minutes, serially diluted, and plated for CFUs. Formalin preserved the other for biofilm evaluation by scanning electron microscopy. Next, tubes were exposed to five drops of Ciprofloxacin, Ciprofloxacin/Dexamethasone, Dexamethasone, Ofloxacin, or saline for 1 hour. Afterward, the ototopicals were removed and sterile broth was placed in the wells as a nutrient. This was repeated every 12 hours for 5, 10, 14, and 21 days of treatment. Prior to the last dose of treatment intervals, a streak plate was performed to evaluate for microbial growth in the wells. The tubes were evaluated for CFUs and biofilms at each interval as previously described. RESULTS: Microbial activity in CFUs decreased by day 5 and continued through day 21 for the antibiotic containing drops. Despite treatment, the biofilm was never eradicated and continued to progress. CONCLUSIONS: Infectivity of the biofilm is neutralized by antibiotic ototopicals; however, the biofilm will progress despite treatment.
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