AOM is the most common reason for antimicrobial prescribing in US children, and due to the high prevalence of disease and frequent recurrences is believed to be partially responsible for the ongoing increase in antibiotic resistance among pathogenic bacteria. Local, sustained delivery of active therapeutics directly to the middle ear for the treatment of OM could potentially allow for much higher middle ear drug concentrations than from systemic administration, which could allow for a faster and more complete eradication of OM bacteria, while minimizing systemic exposure and its adverse effects, particularly selection of drug-resistant bacteria. We have recently described a hydrogel containing antibiotics and chemical permeation enhancers that was capable of enhancing antibiotic flux across the tympanic membrane, to produce a sufficient flux of antibiotic across the tympanic membrane (TM) from a single application to be able to treat OM. We have subsequently optimized this formulation in terms of gelation properties and adherence to the eardrum, and shown efficacy in a model of otitis media. We hypothesize that these formulations will also be able to prevent OM, and mitigate biofilm formation in the middle ear. Here we propose a research plan that will help in translating that proof-of-concept toward a clinical reality. Toward that end, we have assembled a multidisciplinary and multi-institutional collaboration with a proven track record of working together.

Public Health Relevance

Middle ear infections are the most commonly treated infections in childhood. We have developed gels that contain chemicals that will help antibiotics cross the eardrum; the gel holds them in place. We demonstrate that these gels could cure these infections with a single application, and will study whether they could be used to prevent recurrences. This approach could prevent also antibiotic resistance. The research in this application is geared toward moving this benchtop research toward becoming a clinical reality.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
1R01DC015050-01A1
Application #
9171151
Study Section
Special Emphasis Panel (ZDC1-SRB-R (40))
Program Officer
Watson, Bracie
Project Start
2016-07-22
Project End
2021-06-30
Budget Start
2016-07-22
Budget End
2017-06-30
Support Year
1
Fiscal Year
2016
Total Cost
$580,650
Indirect Cost
$199,913
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115