In vitro Evaluation of a Hypobromous Acid Hygiene Stabilized Solution in the Reduction of Bacterial Load Associated to Blepharitis Conditions

Abstract

Aims: Blepharitis is a chronic inflammation of the periocular skin area and it is characterized by eye itching, burning, dryness and irritation, with progression to chronic dry eye syndrome, where the eyelids margins of blepharitis patients are frequently colonized by bacteria. The aim of the present study was to investigate the in vitro bactericidal activity (BA) of a stabilized active bromine solution (MDI-102) at neutral pH for the potential use in the treatment and prevention of blepharitis. Methods and Results: The kinetic experiments have been conducted both in clean and in dirty conditions (by using bovine albumin solution as the interfering substance) at different ranges of concentration. The results show the topical solution to be capable of inactivating, in less than 0.5 minutes, more than 99.9% of several bacterial species involved in the clinical manifestations of blepharitis: Enterococcus hirae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Serratia marcescens. Dirty condition tests confirm the results shown without albumin (clean conditions). Conclusions: MDI-102 is considered not irritating and dermatologically tested. This study demonstrates that MDI-102 active bromine solution can markedly reduce (in vitro) the bacterial activity, responsible of clinical manifestation of blepharitis. Thus, MDI-102 can be considered a promising tool for the periocular area and eyelids cleaning for blepharitis patients. Significance and Impact of the Study: The use of this formulation may contribute in the long-term prevention and hygienic treatment of blepharitis condition. Furthermore, MDI-102 can be considered as an alternative to reduce the use and the abuse of topical antibiotics in the daily practice, which may contribute to the increase of resistance to the antibiotics in the clinical setting.