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Autumn 2016


pediatrics; infection

drawing of the inner ear
Middle-ear anatomy

A single-application bioengineered gel squirted into the ear canal could deliver a full course of antibiotic therapy for middle-ear infections and make treatment of this common childhood illness much easier and safer, according to an animal study conducted by HMS researchers at Boston Children’s Hospital and Massachusetts Eye and Ear. The findings appeared September 14 in Science Translational Medicine.

Middle-ear infection, or otitis media, prompts 12 to 16 million clinical visits per year in this country alone and is the number one reason for pediatric antibiotic prescriptions. But, as parents know, getting young children to take oral antibiotics several times daily for 7 to 10 days is daunting.

Children also seem to get better within a few days, so parents often stop treatment too soon. Incomplete treatment and frequent recurrence of otitis media—40 percent of children have four or more episodes—encourage the development of drug-resistant infections. And because high doses are needed to get enough antibiotic to the ear, side effects like diarrhea, rashes, and oral thrush are common.

The gel was tested in chinchillas, rodents that have an ear structure similar to that of humans. Further tests will be needed to determine safety and efficacy in humans.

Squirted into the ear canal, the gel quickly hardens and stays in place while it gradually dispenses antibiotics across the eardrum into the middle ear.

The bioengineered gel gets drugs past the eardrum barrier with the help of chemical permeation enhancers (CPEs), compounds that are FDA-approved for other uses. The CPEs, which are structurally similar to the lipids in the eardrum’s outermost layer, insert themselves into the membrane and open molecular pores that allow the antibiotics to seep through.   

Image: SPL/Science Source

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