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Penetration of enoxacin into middle ear effusion
1Department of Otorhinolaryngology, Central Hospital, Karlskrona, Sweden.
Abstract:
An oral dose of 400 mg enoxacin was given to each of 19 patients with long-standing secretory otitis media (SOM). A total of 27 samples of middle ear effusion (MEE) and blood were collected at different intervals during a 6-h period after administration of the drug. The concentration of enoxacin in MEE and serum was determined by a microbiological agar-well diffusion method. Enoxacin was found to penetrate rapidly into MEE but was eliminated slowly. The concentration in MEE was about the same at one hour as at 6 h (median value 0.6 mg/l) with a slight peak at 4 h (median value 0.9 mg/l). The peak in blood occurred after one hour (median value 1.8 mg/l), followed by a slow decrease in the concentration during the 6 h studied. The concentration of enoxacin in MEE exceeded the MICs of some (but not all) pathogens usually responsible for infections in chronic otitis media.
Insights
Enoxacin rapidly enters middle ear fluid (MEF) in patients with secretory otitis media (SOM), remaining detectable for hours. This antibiotic penetration may be beneficial for treating certain ear infections.
Area of Science:
- Pharmacology
- Otolaryngology
- Infectious Diseases
Background:
- Secretory otitis media (SOM) is a common condition characterized by fluid in the middle ear.
- Effective antibiotic penetration into the middle ear effusion (MEE) is crucial for treating associated infections.
Purpose of the Study:
- To evaluate the penetration and elimination kinetics of enoxacin in the middle ear effusion (MEE) of patients with secretory otitis media (SOM).
- To determine if enoxacin concentrations in MEE reach levels sufficient to inhibit common otitis media pathogens.
Main Methods:
- Oral administration of 400 mg enoxacin to 19 patients with SOM.
- Collection of middle ear effusion (MEE) and serum samples over a 6-hour period.
- Quantification of enoxacin concentrations using a microbiological agar-well diffusion assay.
Main Results:
- Enoxacin demonstrated rapid penetration into the MEE.
- Enoxacin concentrations in MEE were sustained, with median values of 0.6 mg/l at 1 and 6 hours, and a peak of 0.9 mg/l at 4 hours.
- Serum peak concentration (1.8 mg/l) occurred at 1 hour, followed by a gradual decline.
- MEE enoxacin levels exceeded the Minimum Inhibitory Concentrations (MICs) for some, but not all, relevant pathogens.
Conclusions:
- Enoxacin exhibits favorable pharmacokinetic properties for targeting middle ear infections in SOM.
- The sustained presence of enoxacin in MEE suggests potential therapeutic efficacy against specific bacterial pathogens implicated in chronic otitis media.