{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:02:39Z","timestamp":1781787759141,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009727","name":"Hospital Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003354","name":"Garnett Passe and Rodney Williams Memorial Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003354","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Topical budesonide (Pulmicort; AstraZeneca AB, Sodertalje, Sweden) is commonly used in the management of chronic rhinosinusitis (CRS). Although its use is due to its perceived anti\u2010inflammatory effect, studies have suggested that it may also have antibacterial properties. To make the hydrophobic steroid molecule suitable for topical administration, pharmaceutical excipients are used in commercial steroid formulations. Herein we investigated the antibacterial action of commercial budesonide and its excipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Planktonic and biofilm forms of <jats:italic>Staphylococcus aureus<\/jats:italic> and methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) were treated with Pulmicort or its excipients at clinically relevant concentrations. Bacterial growth was determined by optical density, resazurin assays, colony\u2010forming unit counts, and Giemsa staining. Minimum inhibitory concentration (MIC) studies assessed excipients\u2019 potentiation of antibiotics. Experiments were conducted in triplicate and results analyzed using one\u2010way analysis of variance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was significant reduction in planktonic and biofilm growth of <jats:italic>S aureus<\/jats:italic> and MRSA on exposure to budesonide (<jats:italic>p<\/jats:italic> &lt; 0.0001) and its excipients (<jats:italic>p<\/jats:italic> &lt; 0.0001). Excipient ethylene diamine\u2010tetraactic acid (EDTA) demonstrated an antibacterial property even at the low concentrations used in topical preparations (<jats:italic>p<\/jats:italic> &lt; 0.0001). With amoxicillin, excipients exhibited a potential additive\/synergistic effect on MIC, whereas erythromycin and aminoglycosides showed an antagonistic action.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The commercial product Pulmicort has a direct antibacterial effect on the planktonic and biofilm forms of <jats:italic>S aureus<\/jats:italic> and MRSA. This effect is at least in part mediated through the excipient EDTA in the product. Excipients also influenced the antimicrobial activity of antibiotics depending on the bacterial strain and antibiotic tested.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22312","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T16:59:07Z","timestamp":1549990747000},"page":"766-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of commercial nasal steroid preparation on bacterial growth"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9025-6613","authenticated-orcid":false,"given":"Lisa Mary","family":"Cherian","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Cooksley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnaz","family":"Ramezanpour","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathish","family":"Paramasivan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter\u2010John","family":"Wormald","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Vreugde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkis James","family":"Psaltis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, University of Adelaide  Woodville South SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.7544"},{"key":"e_1_2_7_3_1","first-page":"513","article-title":"Multiple actions of steroid hormones\u2014a focus on rapid, nongenomic effects","volume":"52","author":"Falkenstein E","year":"2000","journal-title":"Pharmacol Rev"},{"key":"e_1_2_7_4_1","first-page":"956","article-title":"In vitro glucocorticoid receptor binding and transcriptional activation by topically active glucocorticoids","volume":"48","author":"Smith CL","year":"1998","journal-title":"Arzneimittelforschung"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24322"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546630050517289"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-003-4080-y"},{"key":"e_1_2_7_8_1","unstructured":"US Food and Drug Administration.Division of Drug Information Resources Office of Management Center for Drug Evaluation and Research. 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