Anti-inflammatory response to 1,8-Cineol is associated with colonic presence of Prevotella copri in Otitis media patients

Chronic Otitis Media (COM) is associated with middle ear long-term inflammation and colonization with pathogenic bacteria, leading to conductive hearing loss. Standard antibiotic treatment and surgical interventions are often augmented by antibiotic resistance development. As part of an innovative treatment approaches, off-label treatment testing using the natural drug 1,8-Cineol was carried out. Methods: All COM patients (n = 12) selected for the study underwent antibiotic therapy and middle ear surgery and developed antibiotic resistances. Therefore, administration of 1,8-Cineol was performed in terms of the clinically approved drug Soledum Kapseln forte® (capsules) without any additional antibiotic treatment. Microbiological investigations from the auditory canal and fecal samples were performed in correlation with the clinical course. Results: Data revealed in vitro grow-inhibitory effects of 1,8-Cineol against Klebsiella pneumoniae, Enterococcus cloacae, Pseudomonas aeruginosa, and Staphylococcus aureus. Off-label therapy of COM patients with 1,8-Cineol revealed a clear reduction of inflammatory microbes P. aeruginosa and Proteus mirabilis in ear samples as well as intestinal Prevotella copri and an improved clinical outcome in certain individuals. Distinct changes in the microbiome patterns in intestinal bacterial community were associated with higher response to therapy. Conclusions: The present off-label study revealed manifold anti-inflammatory and health-promoting effects of the natural monoterpene 1,8-Cineol in Otitis media patients. A better understanding of the underlying mechanisms will improve the current treatment options and possible forms of application of this natural drug.