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M.E. Tepedino; Microbiological Analyses of the Activity of 7 Antiinfectives Against Isolates from Patients with Acute Bacterial Conjunctivitis . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4914.
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Purpose: To evaluate bacterial isolates from patients with acute bacterial conjunctivitis in terms of their minimal inhibitory concentrations (MIC) and susceptibilities to gatifloxacin, 4 other fluoroquinolones, and tobramycin. Methods: Conjunctival swabs were taken at baseline and again at day 5 from 104 patients enrolled in a randomised, parallel–group clinical comparison of gatifloxacin ophthalmic solution (ZYMARTM) 0.3% administered either BID or QID. These swabs were then cultured, and the bacterial isolates were analysed in vitro in terms of their susceptibilities to gatifloxacin (GAT), moxifloxacin (MOX), ciprofloxacin (CIP), levofloxacin (LEV), ofloxacin (OFL), and tobramycin (TOB) according to NCCLS definitions using a broth dilution method. MIC90s were determined if at least 5 isolates were collected. Results: The MIC90s (mg/L) for all isolates from the baseline swabs were as follows: GAT, 0.50 (n = 102); MOX, 0.50 (n = 100); CIP, 2.0 (n = 100); LEV, 1.0 (n = 100); OFL, 2.0 (n = 100); and TOB, 32.0 (n = 100). For the swabs taken at day 5, the MIC90s (mg/L) were GAT, 2.0 (n= 5); MOX, 4.0 (n= 7); CIP, 32.0 (n= 7); LEV, 16.0 (n= 7); OFL, 32.0 (n= 7); and TOB, 128.0 (n= 7). The overall susceptibilities at baseline were: GAT, 96.1%; MOX, 97.0%; CIP, 88.0%; LEV, 92.0%; OFL, 92.0%; and TOB, 70.0%. At day 5, they were: GAT, 100.0%; MOX, 85.7%; CIP, 42.9%, LEV, 57.1%; OFL, 57.1%; and TOB, 71.4%. Baseline included 18 Gram–negative and 84 Gram–positive organisms, with the most common ones being Staph. epidermidis (n = 25), Staph. aureus (n = 16), and Strep. pneumoniae (n = 16). In the clinical study, the BID dosing regimen was equally as effective as QID. Conclusions: The 4th generation fluoroquinolones GAT and MOX were more effective than the earlier generations of fluoroquinolones and TOB based on the MIC and susceptibility results of this study.
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