Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-27T23:23:34.388Z Has data issue: false hasContentIssue false

Effects of azelastine nasal spray on nasal and nasopharyngeal microflora

Published online by Cambridge University Press:  30 October 2015

F Aksoy
Affiliation:
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
E Senturk*
Affiliation:
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
R Doğan
Affiliation:
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
B Veyseller
Affiliation:
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
O Ozturan
Affiliation:
Department of Otorhinolaryngology, Bezmialem Vakif University, Fatih, Istanbul, Turkey
N Gönüllü
Affiliation:
Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, University of Istanbul, Fatih, Istanbul, Turkey
F Yilmaz
Affiliation:
Department of Microbiology and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, University of Istanbul, Fatih, Istanbul, Turkey
*
Address for correspondence: Dr Erol Senturk, Department of Otorhinolaryngology, Medical Faculty, Bezmialem Vakif University, Fatih, Istanbul, Turkey Fax: +90 212 533 2326 E-mail: [email protected]

Abstract

Objective:

Azelastine nasal spray is a topical antihistaminic drug for the symptomatic treatment of allergic rhinitis. This study aimed to investigate the effects of azelastine on nasal and nasopharyngeal microflora.

Methods:

Swab samples from 25 patients prescribed azelastine nasal spray monotherapy were collected just before treatment and after 1 month of treatment. After incubation of inoculates, the number of bacteria present in cultures was measured (in colony-forming units per millilitre).

Results:

Evaluation of the number of microflora revealed increased bacterial reproduction after treatment, but this difference was not statistically significant. The use of azelastine nasal spray decreased the reproduction of three potentially pathogenic bacteria; however, it did not affect the reproduction of other potentially pathogenic bacteria.

Conclusion:

The use of azelastine nasal spray for one month did not have a statistically significant effect on the numbers of nasal and nasopharyngeal microflora; it is therefore safe from a microbiological viewpoint.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Horak, F, Zieglmayer, UP. Azelastine nasal spray for the treatment of allergic and nonallergic rhinitis. Expert Rev Clin Immunol 2009;5:659–69CrossRefGoogle ScholarPubMed
2Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8160CrossRefGoogle Scholar
3Zechel, HJ, Brock, N, Lenke, D, Achterrath-Tuckermann, U. Pharmacological and toxicological properties of azelastine, a novel anti-allergic agent. Arzneimittelforschung 1981;31:1184–93Google Scholar
4Greiff, L, Andersson, M, Svensson, C, Persson, CG. Topical azelastine has a 12-hour duration of action as assessed by histamine challenge-induced exudation of alpha 2-macroglobulin into human nasal airways. Clin Exp Allergy 1997;27:438–44CrossRefGoogle Scholar
5Davies, RJ, Bagnall, AC, McCabe, RN, Calderon, MA, Wang, JH. Antihistamines: topical vs oral administration. Clin Exp Allergy 1996;26:1117CrossRefGoogle ScholarPubMed
6Horak, F, Jager, S, Toth, J, Kavina, A, Marschall, K, Munzel, U et al. Azelastine in pollen-induced allergic rhinitis – a pharmacodynamic study of onset of action and efficacy. Drug Invest 1994;7:3440CrossRefGoogle Scholar
7Chand, N, Pillar, J, Nolan, K, Diamantis, W, Sofia, RD. Inhibition of allergic and nonallergic leukotriene C4 formation and histamine secretion by azelastine: implication for its mechanism of action. Int Arch Allergy Appl Immunol 1989;90:6770CrossRefGoogle ScholarPubMed
8Hamasaki, Y, Shafigeh, M, Yamamoto, S, Sato, R, Zaitu, M, Muro, E et al. Inhibition of leukotriene synthesis by azelastine. Ann Allergy Asthma Immunol 1996;76:469–75CrossRefGoogle ScholarPubMed
9Nieber, K, Baumgarten, C, Rathsack, R, Furkert, J, Laake, E, Müller, S et al. Effect of azelastine on substance P content in bronchoalveolar and nasal lavage fluids of patients with allergic asthma. Clin Exp Allergy 1993;23:6971CrossRefGoogle ScholarPubMed
10Shinoda, M, Watanabe, N, Suko, T, Mogi, G, Takeyama, M. Effects of anti-allergic drugs on substance P (SP) and vasoactive intestinal peptide (VIP) in nasal secretions. Am J Rhinol 1997;11:237–41CrossRefGoogle Scholar
11Ito, H, Nakamura, Y, Takagi, S, Sakai, K. Effects of azelastine on the level of serum interleukin-4 and soluble CD23 antigen in the treatment of nasal allergy. Arzneimittelforschung 1998;48:1143–7Google ScholarPubMed
12Ciprandi, G, Pronzato, C, Passalacqua, G, Ricca, V, Grögen, J, Mela, GS et al. Topical azelastine reduces eosinophil activation and intercellular adhesion molecule-1 expression on nasal epithelial cells: an antiallergic activity. J Allergy Clin Immunol 1996;98:1088–96CrossRefGoogle ScholarPubMed
13Berdal, JE, Bjørnholt, J, Blomfeldt, A, Smith-Erichsen, N, Bukholm, G. Patterns and dynamics of airway colonisation in mechanically-ventilated patients. Clin Microbial Infect 2007;13:476–80CrossRefGoogle ScholarPubMed
14Montagnini, SD, Mamizuka, EM, Pereira, CA, Srougi, M. Microbiologic aerobic studies on normal male urethra. Urology 2000;56:207–10CrossRefGoogle Scholar
15Koneman, EW, Allen, SD, Janda, WM, Schreckenberger, BC, Win, WC. Color Atlas and Text Book of Diagnostic Microbiology, 4th edn.Philadelphia: JB Lippincott, 1997Google Scholar
16Ratner, PH, Findlay, SR, Hampel, F, van Bavel, J, Widlitz, MD, Freitag, JJ. A double-blind, controlled trial to assess the safety and efficacy of azelastine nasal spray in seasonal allergic rhinitis. J Allergy Clin Immunol 1994;94:818–25CrossRefGoogle ScholarPubMed
17Salib, JR, Howarth, PH. Safety and tolerability profiles of intranasal antihistamines and intranasal corticosteroids in the treatment of allergic rhinitis. Drug Saf 2003;26:863–93CrossRefGoogle ScholarPubMed
18Shah, S, Berger, W, Lumry, W, La Force, C, Wheeler, W, Sacks, H. Efficacy and safety of azelastine 0.15% nasal spray and azelastine 0.10% nasal spray in patients with seasonal allergic rhinitis. Allergy Asthma Proc 2009;30:628–33CrossRefGoogle ScholarPubMed
19Kempuraj, D, Huang, M, Kandere, K, Boucher, W, Letourneau, R, Jeudy, S et al. Azelastine is more potent than olopatadine in inhibiting interleukin-6 and tryptase release from human umbilical cord blood-derived cultured mast cells. Ann Allergy Asthma Immunol 2002;88:501–6CrossRefGoogle ScholarPubMed
20Matsuo, S, Takayama, S. Influence of the anti-allergic agent, azelastine, on tumor necrosis factor-alpha (TNF-α) secretion from cultured mouse mast cells. In Vivo 1998;12:481–4Google ScholarPubMed
21Beck, G, Mansur, A, Afzal, M et al. Effect of azelastine nasal spray on mediators of inflammation in patients with seasonal allergic rhinitis (SAR). Presented at the 56th annual meeting of the American Academy of Allergy, Asthma, and Immunology, San Diego, CA, 3–8 March 2000.Google Scholar
22Yoneda, K, Yamamoto, T, Ueta, E, Ueta, E, Osaki, T. Suppression by azelastine hydrochloride of NF-κB activation involved in generation of cytokines and nitric oxide. Jpn J Pharmacol 1997;73:145–53CrossRefGoogle ScholarPubMed
23Busse, W, Randley, B, Sedgwick, J. The effect of azelastine on neutrophil and eosinophil generation of superoxide. J Allergy Clin Immunol 1989;83:400–5CrossRefGoogle ScholarPubMed
24Umeki, S. Effects of anti-allergic drops on human neutrophil superoxide-generating NADPH oxidase. Biochem Pharmacol 1992;43:1109–17CrossRefGoogle Scholar
25Glück, U, Gebbers, JO. Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci). Am J Clin Nutr 2003;77:517–20CrossRefGoogle ScholarPubMed
26Smith, CL, Kreutner, W. In vitro glucocorticoid receptor binding and transcriptional activation by topically active glucocorticoids. Arzneimittelforschung 1998;48:956–60Google ScholarPubMed
27Aksoy, F, Demirhan, H, Bayraktar, , Yıldırım, YS, Ozturan, O, Gönüllü, N et al. Effect of nasal mometasone furoate on the nasal and nasopharyngeal flora. Auris Nasus Larynx 2012;39:180–5CrossRefGoogle ScholarPubMed