Does topical application of ofloxacin to the intact tympanic membrane (TM) compare to systemic administration?
Explore this issue:October 2010
Background: Acute otitis media (AOM) is routinely treated with systemic antibiotics, which have been linked to antibiotic-resistant strains of bacteria. Generally, topical therapy is considered appropriate if the TM is nonintact and permits solutions placed in the external auditory canal to enter the middle ear space. Children with AOM, however, have an intact TM.
Study design: A prospective, controlled animal study
Setting: University of Texas Southwestern Medical Center at Dallas and University of Texas at Dallas
Synopsis: Twenty-five rats underwent surgery in which the middle ear cavity was opened and filled with saline. The Eustachian tube remained closed in the anesthetized animals. An equivalent amount of ofloxacin was delivered intraperitoneally or into the external ear canal. Saline within the middle ear was sampled and completely replaced in 15-minute intervals for three hours; blood was collected twice. When animals were sacrificed three hours after the initial addition of ofloxacin, the authors found that both systemic and otic applications led to a comparable accumulation of ofloxacin in the middle ear as well as in blood serum, urine and colonic mucosa. The pharmacokinetics of ofloxacin penetration was sporadic and subject-dependent.
Bottom Line: Topical application of ofloxacin to the intact TM allows for fast drug penetration into the middle ear space and is a possible treatment for AOM with the intact TM.
Citation: Koulich E, Roland PS, Pawlowski KS. Comparison of systemic and otic administration of ofloxacin. Laryngoscope. 2010;120(10):2083-2088.
—Reviewed by Sue Pondrom