Garlic and Clove for Otitis Media in Older Adults: Antimicrobial Mechanisms, Synergy, Safety, and Topical Therapeutic Potential
DOI:
https://doi.org/10.65336/Keywords:
Otitis media, geriatric patients, Allium sativum, Syzygium aromaticum, garlic, antimicrobial resistanceAbstract
Otitis media remains an important cause of morbidity in older adults, particularly when chronic or recurrent disease is complicated by immunosenescence, diabetes mellitus, Eustachian tube dysfunction, polymicrobial infection and antimicrobial resistance. In geriatric patients, chronic suppurative otitis media may be associated with persistent otorrhoea, hearing impairment, vestibular dysfunction and, in severe cases, intracranial complications. The increasing prevalence of multidrug-resistant otopathogens and biofilm-associated infections has stimulated interest in plant-derived antimicrobial agents as potential adjuncts to conventional therapy. This review examines the therapeutic potential of garlic (Allium sativum) and clove (Syzygium aromaticum) in the management of otitis media in older adults, with emphasis on their phytochemical composition, antimicrobial and anti-inflammatory mechanisms, possible synergistic effects, safety considerations and prospects for topical formulation. Garlic is rich in organosulfur compounds, particularly allicin, ajoene and diallyl sulfides, which exhibit antimicrobial, antibiofilm, antioxidant and immunomodulatory activities. Clove contains high concentrations of eugenol and other phenolic compounds with antimicrobial, analgesic, antioxidant and anti-inflammatory properties. Their combined use may provide complementary mechanisms through membrane disruption, inhibition of microbial enzymes, suppression of biofilm formation and modulation of inflammatory pathways such as NF-κB and COX-2. However, current evidence is derived predominantly from in vitro, animal and phytochemical studies, with limited geriatric-specific clinical data. Concerns regarding ototoxicity, local irritation, tympanic membrane integrity, drug interactions, antiplatelet effects and variability in extract composition must also be addressed. Garlic and clove therefore represent promising candidates for further investigation as adjunctive agents in otitis media, but standardized formulations, rigorous toxicological evaluation and well-designed clinical trials are required before routine clinical use can be recommended.
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