中文摘要：尽管疫苗与阿莫西林联合抗菌治疗肺炎球菌取得了巨大成功，但急性中耳炎（AOM）仍然是一个严重的医学问题。妨碍抗菌治疗的因素有以下几种：中耳腔被骨组织包围，很难维持足够的抗生素浓度；AOM患者的鼓膜增厚，成为局部治疗的障碍。本文综述了基于给药系统(DDS)的AOM新型抗菌治疗策略。为了提供足够的药物来杀死病原菌而不产生系统性副作用，应用创新药物DDS开发新的抗菌治疗策略备受期待。缓释DDS可以使时间依赖性抗生素的浓度超过最小抑菌浓度（MIC）的时间足够长，并使剂量依赖性抗生素维持最大剂量浓度，以消除中耳炎致病菌。开发经鼓膜DDS，如化学渗透增强剂水凝胶（CPE），是另一种可行的策略。噬菌体是一种前景很好的基于DDS的治疗策略。DDS制剂能通过单剂量对AOM进行抗菌治疗，因此未来是一种有吸引力的AOM抗菌疗法。
外文摘要：Despite tremendous success of pneumococcal conjugated vaccine and antimicrobial treatment by amoxicillin, acute otitis media (AOM) still remains as a great medical concern. Failure of antimicrobial treatment includes several factors. The middle ear cavity is surrounded by bone tissue, which makes it difficult to maintain sufficient concentration of antibiotics. Tympanic membrane of AOM patients thickens and actually becomes a barrier for topical therapy. This review discusses novel antimicrobial treatment strategies based on drug delivery systems (DDS) for AOM. To deliver drugs enough to kill the pathogenic bacteria without systemic side effects, the development of new antimicrobial treatment strategy applying innovative drug DDS has been expected. The sustained-release DDS can achieve sufficient time for antimicrobial concentrations to exceed minimum inhibitory concentration (MIC) for time-dependent antibiotics as well as enough maximum concentration for dose-dependent antibiotics to eradicate causative pathogens in the middle ear. The development of trans-tympanic membranes of DDS, such as hydrogels with chemical permeation enhancers (CPEs), is another attractive strategy. Phage is a promising strategy for developing DDS-based therapies. The DDS formulations enable antimicrobial treatment of AOM by a single dose and thus, an attractive future antimicrobial treatment for AOM.
外文关键词：acute otitis media；drug delivery system；sustained release；antibiotics; PK/PD
作者：Kono, M；Umar, NKK；Takeda, S；Ohtani, M；Murakami, D；Sakatani, H；Kaneko, F；Nanushaj, D；Hotomi, M
作者单位：Wakayama Med Univ
期刊名称：FRONTIERS IN PHARMACOLOGY
期刊影响因子：4.225
出版年份：2021
出版刊次：12
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