Effects of Ciprofloxacin/Dexamethasone and Ofloxacin on Tympanic Membrane Perforation Healing

Abstract

HYPOTHESIS:: Exposure to ciprofloxacin/dexamethasone, but not ofloxacin, prolongs tympanic membrane (TM) healing. BACKGROUND:: Exposure to hydrocortisone has been shown to delay TM wound healing. No published studies have compared the effects of ciprofloxacin/dexamethasone and ofloxacin on TM healing. METHODS:: Noninfected TM perforations were created in 30 rats. The rats were split into three groups, and ciprofloxacin/dexamethasone, ofloxacin, or isotonic sodium chloride solution drops were instilled for 8 days. Tympanic membrane healing was analyzed at specified intervals using photographic documentation verified by a blinded observer. RESULTS:: The isotonic sodium chloride solution control and ofloxacin-exposed TMs healed at similar rates. There was a statistically significant delay in TM healing in the ciprofloxacin-/dexamethasone-exposed TMs by postoperative Day 10. However, all TM perforations were healed by postoperative Day 20. CONCLUSION:: Ciprofloxacin/dexamethasone delays healing of experimental TM perforations, but the brief exposure in this study did not cause persistent perforations.

The effect of ofloxacin otic drops on the regeneration of human traumatic tympanic membrane perforations

“…Our two recent studies demonstrated that moist perforations with bloody or watery otorrhoea significantly shortened the closure time and improved the closure rate versus dry perforations . In addition, previous studies found that topical antibiotic treatment did not cause TMPs to persist . These findings prompted us to design a clinical study to assess whether a moist eardrum environment resulting from only the topical application of sterile and non‐ototoxic ear drops could accelerate eardrum healing and improve the closure rate.…”

Topical Dexamethasone and Tympanic Membrane Perforation Healing in Otitis Media

“…Previous studies (11,12) have shown that oto-topical ciprofloxacin-dexamethasone administration delays TM healing in animal models. These studies did not examine TM healing in the presence of AOM, which results in a more robust healing response (13) and a reduced risk of persistent perforation (14).…”

Detection of endogenous cortisol in equine tears and blood at rest and after simulated stress

“…Despite the beneficial anti‐inflammatory effects of corticosteroids, there are potential negative effects on corneal healing, which frequently preclude their use in equine ulcerative keratitis. Corticosteroids have been associated with a delayed repair in several nonocular tissues . Specific to ophthalmology, corticosteroids have been found to retard corneal epithelial defect closure and contribute to lower corneal stromal cell density in a dose‐dependent manner .…”

“…Corticosteroids have been associated with a delayed repair in several nonocular tissues. [5][6][7] Specific to ophthalmology, corticosteroids have been found to retard corneal epithelial defect closure and contribute to lower corneal stromal cell density in a dose-dependent manner. [8][9][10][11] Additionally, in vitro stimulation of corticosteroid receptors with the potent synthetic corticosteroid dexamethasone stimulates proliferation of human keratocytes, but simultaneously induces apoptosis and necrosis in these cells.…”

“…20,21 These stress factors often combine in the hospitalized equine ophthalmic patient and could result in increases in endogenous cortisol in tears as well as serum. High concentrations of endogenous cortisol in the tear film could thus potentially delay epithelialization, [5][6][7][8][9][10][11]22 encourage growth of bacteria or fungus, [12][13][14] or activate MMPs 15 as described for exogenous corticosteroids and therefore might contribute to ulcer expansion in horses with corneal disease.…”