{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:44:13Z","timestamp":1781588653178,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 DC011818"],"award-info":[{"award-number":["R01 DC011818"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["DC011818"],"award-info":[{"award-number":["DC011818"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01"],"award-info":[{"award-number":["R01"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the ability of humanized monoclonal antibody fragments directed against a bacterial DNABII protein plus ofloxacin delivered directly into the chinchilla middle ear via tympanostomy tube (TT) to enhance the ability of ofloxacin to eradicate biofilms formed by nontypeable <jats:italic>Haemophilus influenzae<\/jats:italic> (NTHI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A blinded pre\u2010clinical study of comparative efficacy of single versus combinatorial treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>NTHI was allowed to form biofilms in the middle ears of chinchillas prior to TT placement. Ofloxacin, humanized Fab fragments against a bacterial DNABII protein that disrupts biofilms or Fab fragments plus ofloxacin were instilled into the middle ear via TT. For two consecutive days, ofloxacin was delivered twice\u2010a\u2010day, Fab fragments were delivered once\u2010a\u2010day, or these treatments were combined. Relative biofilm resolution (as determined via two outcome measures) and eradication of viable NTHI were assessed 1\u2010day later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Whereas ofloxacin alone did not resolve biofilms or eradicate NTHI from the middle ear, delivery of Fab fragments significantly reduced both biofilms and NTHI burden over this short course of treatment. Notably, co\u2010delivery of ofloxacin plus humanized Fab fragments eradicated both NTHI and biofilms from the middle ear, an enhanced outcome compared to receipt of either treatment alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated a powerful combinatorial approach to release bacteria from their protective biofilms and rapidly render them vulnerable to killing by a previously ineffective antibiotic. An approach to combine ofloxacin with humanized Fab fragments that disrupt biofilms has tremendous potential to quickly resolve chronic otorrhea suffered by children with chronic suppurative otitis media or chronic post\u2010tympanostomy tube otorrhea and thereby improve their quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 131:E2698\u2013E2704, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29497","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T10:49:22Z","timestamp":1614941362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Humanized <scp>Anti\u2010DNABII<\/scp> Fab Fragments Plus Ofloxacin Eradicated Biofilms in Experimental Otitis Media"],"prefix":"10.1002","volume":"131","author":[{"given":"Laura A.","family":"Novotny","sequence":"first","affiliation":[{"name":"Center for Microbial Pathogenesis Abigail Wexner Research Institute at Nationwide Children's Hospital  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1448-5873","authenticated-orcid":false,"given":"Tendy","family":"Chiang","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"Department of Pediatric Otolaryngology Nationwide Children's Hospital  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Center for Microbial Pathogenesis Abigail Wexner Research Institute at Nationwide Children's Hospital  Columbus Ohio U.S.A."},{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1890-2876","authenticated-orcid":false,"given":"Charles A.","family":"Elmaraghy","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."},{"name":"Department of Pediatric Otolaryngology Nationwide Children's Hospital  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0017-1710","authenticated-orcid":false,"given":"Lauren O.","family":"Bakaletz","sequence":"additional","affiliation":[{"name":"Center for Microbial Pathogenesis Abigail Wexner Research Institute at Nationwide Children's Hospital  Columbus Ohio U.S.A."},{"name":"The Ohio State University College of Medicine  Columbus Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery The Ohio State University Wexner Medical Center  Columbus Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.63"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000155"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036226"},{"key":"e_1_2_7_5_1","first-page":"435","article-title":"Otitis media: diagnosis and treatment","volume":"88","author":"Harmes KM","year":"2013","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813487302"},{"key":"e_1_2_7_7_1","first-page":"1","article-title":"Ambulatory surgery data from hospitals and ambulatory surgery centers: United States 2010","volume":"102","author":"Hall MJ","year":"2017","journal-title":"Natl Health Stat Rep"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.113941"},{"key":"e_1_2_7_9_1","first-page":"0507","article-title":"Chronic suppurative otitis media","volume":"2007","author":"Acuin J","year":"2007","journal-title":"BMJ Clin Evid"},{"key":"e_1_2_7_10_1","first-page":"CD013051","article-title":"Topical antibiotics for chronic suppurative otitis media","volume":"1","author":"Brennan\u2010Jones CG","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561320914437"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.6.1771-1776.1999"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2415"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01569816"},{"key":"e_1_2_7_15_1","unstructured":"NIH.NIH guide: research on microbial biofilms. 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