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M.K. Shah, D.C. Ritterband, A.J. Terraciano, G. Fishman, W. Perez, J. Lawrence, J.A. Seedor; Will the Topical Fourth Generation Fluoroquinolones Become the Antibiotics of Choice for Treating Atypical Mycobacteria Related Eye Disease? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1459.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the potency and in vitro susceptibility of atypical mycobacteria isolates to five different fluoroquinolone agents and 3 antibiotics with purported anti-mycobacterial activity. Methods: 16 atypical mycobacteria collected from January 1, 2000- October 1, 2002 and archived at the New York Eye and Ear Infirmary were subcultured on TSA-5% sheep-blood agar (BBL) three times. 9- M. fortuitum, 4- M. chelonae, 2- M. gastri, and 1- M.abscessus were evaluated. A 1 McFarland suspension was prepared from the third subculture and inoculated on 150 mm plates containing Mueller Hinton + 5% sheep blood (BBL). 4 E-test strips were placed on each plate and incubated for 72 hours with 5% CO2. Etest® (AB Biodisk) antimicrobial gradient strips were used for the quantitative determination of MIC and compared to NCCLS standards. The antibiotics tested were moxifloxacin(MX), gatifloxacin(GA), levofloxacin(LE), ciprofloxacin (CL), ofloxacin(MX), clarithromycin(CH), linezolid(LZ), amikacin(AK). Results: The in vitro potency and susceptibility of M. fortuitum was in descending order MX=GA>CL>LE>OF>CH=LZ>AK. The in vitro susceptibility of M. chelonae was in descending order CH>MX=GA=CL=LE>OF=LZ=AK. The in vitro susceptibility of M. gastri was in descending order MX=GA=CL=LE>OF=CH=LZ=AK. M. abscessus was resistant to all tested antibiotics. Conclusions:. The fourth generation fluoroquinolone agents (moxifloxacin, gatifloxacin) demonstrated increased potency over second and third generation fluoroquinolone agents for M. fortuitum and M. gastri. Clarithromycin demonstrated increased potency against M. chelonae compared to all the fluoroquinolones. Clinical studies are needed to confirm our in vitro results.
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