Is Nasodine an effective sinonasal treatment for the management of biofilm-associated chronic rhinosinusitis (CRS)?
Nasodine is an effective antibiofilm agent that is highly active against biofilms of S. aureus ATCC 6538 in vitro and holds promise for the management of sinonasal biofilms in CRS.
BACKGROUND: Bacterial biofilms have been implicated in CRS etiology, and S. aureus biofilms in the paranasal sinuses are associated with more severe disease that is less responsive to treatment. There are very few suitable agents available to manage biofilm-associated CRS. Povidone-iodine is one highly active antiseptic against bacterial biofilms.
STUDY DESIGN: In vitro study.
SETTING: Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
SYNOPSIS: Researchers grew biofilms of S. aureus ATCC 6538 in vitro. Intact biofilms were treated by immersion in 0.9% saline (control), half concentration Nasodine, or full concentration (0.5% povidone-iodine) Nasodine for between five minutes and six hours to ensure detection of the greatest possible range of antibiofilm activity. Further biofilm cells were dispersed into suspension and then treated for between 30 seconds and five minutes. Surviving bacteria were enumerated by culture and counting colonies, and the log10 reduction in viable bacteria was compared with control. Nasodine demonstrated time-and concentration-dependent bacterial killing against intact biofilms. At one hour, treatment with 50% and 100% Nasodine yielded a 1 log10 and a 3.8 log10 reduction in viable bacteria, respectively. At six hours, 100% Nasodine caused near-complete eradication compared with control. For dispersed biofilms, both 50% and 100% Nasodine completely eradicated viable cells to below detection within one minute. Study limitations included the likely shorter residency time for Nasodine in vivo versus in vitro.
CITATION: Hale SJM, Lux CA, Kim R, et al. In vitro Nasodine can be an effective antibiofilm agent for biofilms that may cause CRS. Laryngoscope. 2023;133:2490–2495.