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L. He, A. Carron, D. Cibils, L. Ramirez, J. Carron, M. Samudio, F. Laspina, N. Fariña, R. Sanabria, H. Mino de Kaspar; Efficacy of Topical Ciprofloxacin 0.3% Application in Reducing the Conjunctival Bacterial Load of Patients Undergoing Cataract Extraction. Invest. Ophthalmol. Vis. Sci. 2007;48(13):687.
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To determine the efficacy of a topical ciprofloxacin 0.3% application in the reduction of conjunctival bacterial flora in patients undergoing cataract surgery.
46 eyes of 46 patients were randomized into two groups for this prospective, blinded study after IRB approval was obtained. Baseline bacterial smears were collected for all subjects, both in the study (n = 23) and control (n = 23) groups. Those in the study group received topical 0.3% ciprofloxacin 3 times days the day before surgery. On the day of the surgery, the patients were given one drop of antibiotics every 5 minutes for the hour before surgery, and a smear was collected after this. For the control group, smears were obtained prior to the surgery, but without the administration of any antibiotics. The periorbital surgical field was wiped with 10% povidone-iodine in all patients, and patient eyes were flushed with 10mL of 5% povidone-iodine and a smear collected immediately before surgery. A final smear was collected after the surgery was completed. These smears, along with samples of the aqueous humor immediately prior to and after surgery, were cultured for several days and the bacterial growths identified and quantified.
Positive cultures were collected in 82.6% and 78.2% of the patients at baseline in the study and control groups, respectively. The application of 0.3% ciprofloxacin significantly reduced the colony forming units of bacteria compared to the control group (p<0.05). Immediately after the application of povidone-iodine, the percent of patients with positive cultures dropped to 21.7% in the study group and 8.7% in the control group. After surgery was completed, the percent of positive cultures were 26% in the study and 30.4% in the control group. The bacteria most commonly isolated was coagulase negative Staphylococcus (66.7%).
The administration of 0.3% ciprofloxacin reduced the bacterial load of the conjunctiva in the preoperative period. However, it was unable to eradicate the bacteria completely. Administration of povidone-iodine eradicated the bacteria in 50-70% of the patients about to undergo surgery.
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