Combination Treatment to Improve Mucociliary Transport of Pseudomonas aeruginosa Biofilms.

One of the major challenges associated with chronic respiratory infections in cystic fibrosis and chronic obstructive pulmonary disease is difficult to treat biofilms that form in hyperconcentrated mucus. Biofilms are mechanically robust due to an exterior polymeric matrix that protects from the immune response and antibiotics. Antibiotics like tobramycin alone have little impact on the biofilm matrix, but disruption of viscous mucus and the biofilm architecture has previously been shown to improve antibiotic efficacy. Combination treatments must be used to break up mucus and biofilms and simultaneously kill bacteria. The most promising combination in this study includes the surfactant NP40, the biopolymer hyaluronic acid, and the antibiotic tobramycin which together decreased biofilm viscosity, reduced bacterial load, and increased mucociliary transport rates. The results from this study may be translated to an infected animal study for eventual clinical trials.