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European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 8/2018

01-08-2018 | Rhinology

Antibiofilm effects of amoxicillin–clavulanic acid and levofloxacin in patients with chronic rhinosinusitis with nasal polyposis

Authors: Dragana D. Božić, Bojan Pavlović, Jovica Milovanović, Ana Jotić, Jelena Čolović, Ivana Ćirković

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2018

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Abstract

Purpose

Microbial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP). The aim of our study was to evaluate in vitro effects of amoxicillin–clavulanic acid and levofloxacin on biofilm formation by bacterial species isolated from sinus tissue in patients with CRSwNP.

Methods

The sinus mucosal specimens were harvested from the upper parts and roof of ethmoid cavity of 48 patients with CRSwNP. Each sample was washed thoroughly in three separate beakers of sterile saline to remove any planktonic bacteria and further subjected to microbiology analysis. The biofilm-forming capacity of isolated strains was detected by microtiter-plate method and the effects of subinhibitory (1/2× to 1/16× MIC) and suprainhibitory concentrations (4, 8, 16, 32, and 64 µg/ml) of amoxicillin–clavulanic acid and levofloxacin on biofilm production were investigated.

Results

Bacterial strains were isolated in 42 (87.5%) patients: one microorganism in 80.9% and two microorganisms in 19.1% of patients. The most prevalent bacteria in CRSwNP biofilms were Staphylococcus epidermidis (34%) and S. aureus (28%) followed by S. haemolyticus (12%), Pseudomonas aeruginosa (8%), Moraxella catarrhalis (6%), Streptococcus pneumoniae (6%), and other staphylococci (6%). Subinhibitory concentrations of amoxicillin–clavulanic acid and levofloxacin significantly reduced biofilm formation (p < 0.01 and p < 0.05, respectively), with better efficacy of amoxicillin–clavulanic acid (1/2–1/8× MIC) on staphylococci and levofloxacin (1/2– 1/4× MIC) on M. catarrhalis and P. aeruginosa biofilm formation. Suprainhibitory concentrations of both tested antibiotics (4–64 µg/ml) significantly eradicated mature biofilms of staphylococci (p < 0.01). The effect of levofloxacin on eradication of staphylococcal biofilms was more noticeable, compared to the effect of amoxicillin–clavulanic acid (p < 0.01). Suprainhibitory concentrations of both tested antibiotics had no effect on eradication of previously formed M. catarrhalis and P. aeruginosa biofilms (p > 0.05).

Conclusions

The amoxicillin–clavulanic acid and levofloxacin are shown to be potent antibiofilm agents in patients with CRSwNP. The effects of tested compounds depend on bacterial species and the volume of formed biofilm.
Literature
1.
DeConde AS, Soler ZM (2016) Chronic rhinosinusitis: epidemiology and burden of disease. Am J Rhinol Allergy 30:134–139CrossRefPubMed
2.
Lam K, Schleimer R, Kern RC (2015) The etiology and pathogenesis of chronic rhinosinusitis: a review of current hypotheses. Curr Allergy Asthma Rep 15:41CrossRefPubMedPubMedCentral
3.
4.
Cryer J, Schipor I, Perloff JR, Palmer JN (2004) Evidence of bacterial biofilms in human chronic sinusitis. ORL J Otorhinolaryngol Relat Spec 66:155–158CrossRefPubMed
5.
Bendouah Z, Barbeau J, Hamad WA, Desrosiers M (2006) Biofilm formation by Staphylococcus aureus and Pseudomonas aeruginosa is associated with an unfavorable evolution after surgery for chronic sinusitis and nasal polyposis. Otolaryngol Head Neck Surg 134:991–996CrossRefPubMed
6.
Psaltis AJ, Ha KR, Beule AG et al (2007) Confocal scanning laser microscopy evidence of biofilms in patients with chronic rhinosinusitis. Laryngoscope 117:1302–1306CrossRefPubMed
7.
Singh R, Ray P, Das A, Sharma M (2010) Penetration of antibiotics through Staphylococcus aureus and Staphylococcus epidermidis biofilms. J Antimicrob Chemother 65:1955–1958CrossRefPubMed
8.
9.
Stewart PS (2002) Mechanisms of antibiotic resistance in bacterial biofilms. Int J Med Microbiol 292:107–113CrossRefPubMed
10.
11.
Slavin RG, Spector SL, Bernstein IL (2005) The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol 116:S13–S47CrossRefPubMed
12.
13.
Russell PT, Bekeny JR (2014) Oral antibiotics and the management of chronic sinusitis: what do we know? Curr Opin Otolaryngol Head Neck Surg 22:22–26CrossRefPubMed
14.
15.
Korkmaz H, Ocal B, Tatar EC et al (2014) Biofilms in chronic rhinosinusitis with polyps: is eradication possible? Eur Arch Otorhinolaryngol 1:2695–2702CrossRef
16.
Desrosiers M, Bendouah Z, Barbeau J (2007) Effectiveness of topical antibiotics on Staphylococcus aureus biofilm in vitro. Am J Rhinol 21:149–153CrossRefPubMed
17.
Ha KR, Psaltis AJ, Butcher AR et al (2008) In vitro activity of mupirocin on clinical isolates of Staphylococcus aureus and its potential implications in chronic rhinosinusitis. Laryngoscope 118:535–540CrossRefPubMed
18.
Stammberger H (1999) Surgical treatment of nasal polyps: past, present, and future. Allergy 54(Suppl 53):7–11CrossRefPubMed
19.
Hochstim CJ, Choi JY, Lowe D et al (2010) Biofilm detection with hematoxylin-eosin staining. Arch Otolaryngol Head Neck Surg 136:453–456CrossRefPubMed
20.
Stepanović S, Vuković D, Hola V et al (2007) Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS 115:891–899CrossRefPubMed
21.
Gontcharova V, Youn E, Sun Y et al (2010) A comparison of bacterial composition in diabetic ulcers and contralateral intact skin. Open Microbiol J 4:8–19CrossRefPubMedPubMedCentral
22.
Burmolle M, Thomsen TR, Fazli M et al (2010) Biofilms in chronic infections-a matter of opportunity-monospecies biofilms in multispecies infections. FEMS Immunol Med Microbiol 59:324–336CrossRefPubMed
23.
Boase S, Foreman A, Cleland E et al (2013) The microbiome of chronic rhinosinusitis: culture, molecular diagnostics and biofilm detection. BMC Infect Dis 13:210CrossRefPubMedPubMedCentral
24.
Brook I (2016) Microbiology of chonic rhinosinusitis. Eur J Clin Microbiol Infect Dis 35:1059–1068CrossRefPubMed
25.
Passali D, Mazzei T, Novelli A et al (2001) Amoxicillin/clavulanate in chronic rhinosinusitis: tissue and serum distribution. Acta Otorhinolaryngol Belg 55:259–264PubMed
26.
Gehanno P, Darantiere S, Dubreuil C et al (2002) A prospective, multicentre study of moxifloxacin concentrations in the sinus mucosa tissue of patients undergoing elective surgery of the sinus. J Antimicrob Chemother 49:821–826CrossRefPubMed
27.
Dinis PB, Monteiro MC, Martins ML, Silva N, Gomes A (2000) Sinus tissue pharmacokinetics after oral administration of amoxicillin/clavulanic acid. Laryngoscope 110:1050–1055CrossRefPubMed
28.
Preston SL, Drusano GL, Berman AL et al (1998) Pharmacodynamics of levofloxacin: a new paradigm for early clinical trials. JAMA 279:125–129CrossRefPubMed
29.
Aminimanizani A, Beringer P, Jelliffe R (2001) Comparative pharmacokinetics and pharmacodynamics of the newer fluoroquinolone antibacterials. Clin Pharmacokinet 40:169–187CrossRefPubMed
30.
Chien SC, Rogge MC, Gisclon LG et al (1997) Pharmacokinetic profile of levofloxacin following once-daily 500-milligram oral or intravenous doses. Antimicrob Agents Chemother 41:2256–2260PubMedPubMedCentral
31.
Child J, Mortiboy D, Andrews JM et al (1995) Open-label crossover study to determine pharmacokinetics and penetration of two dose regimens of levofloxacin into inflammatory fluid. Antimicrob Agents Chemother 39:2749–2751CrossRefPubMedPubMedCentral
32.
Pea F, Marioni G, Pavan F et al (2007) Penetration of levofloxacin into paranasal sinuses mucosa of patients with chronic rhinosinusitis after a single 500 mg oral dose. Pharmacol Res 55:38–41CrossRefPubMed
33.
Gehanno P, Farinotti R, Buffe P, Cohen B, Cudennec Y, Sterkers O (1992) Penetration of ciprofloxacin into middle ear and sinus mucosa after repeated oral administration. In: Program and abstracts of the fifth international congress for infectious diseases, Nairobi, Kenya, 1992. Abstract 516. International Society for Infectious Diseases, Boston, p 147
34.
35.
36.
Yassien M, Khardori N (2001) Interaction between biofilms formed by Staphylococcus epidermidis and quinolones. Diagn Microbiol lnfect Dis 40:79–89CrossRef
37.
Eng RHK, Padberg FT, Smith SM et al (1991) Bactericidal effects of antibiotics on slowly growing and nongrowing bacteria. Antimicrob Agents Chemother 35:1824–1828CrossRefPubMedPubMedCentral
38.
Drago L, Mattina R, Legnani D et al (2011) Modulation of biofilm of strains isolated from patients with chronic obstructive pulmonary disease by levofloxacin, moxifloxacin, ciprofloxacin, amoxicillin/clavulanic acid and ceftriaxone. Int J Immunopalhol Pharmacol 24(4):1027–1035CrossRef
39.
Maestre JR, Mateo M, Mendez ML et al (2010) In vitro interference of beta-lactams with biofilm development by prevalent community respiratory tract isolates. Int J Antimicrob Agents 35:274–277CrossRefPubMed
Metadata
Title
Antibiofilm effects of amoxicillin–clavulanic acid and levofloxacin in patients with chronic rhinosinusitis with nasal polyposis
Authors
Dragana D. Božić
Bojan Pavlović
Jovica Milovanović
Ana Jotić
Jelena Čolović
Ivana Ćirković
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 8/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5049-6

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