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K. Terai, M. Joo, J. Hyon, D. Sinha, T.P. O'Brien; Comparative Efficacy of Topical Moxifloxacin, an Expanded Spectrum Fluoroquinolone, versus Topical Ofloxacin, Penicillin G and Tobramycin in the Treatment of Experimental S. pneumoniae and P. aeruginosa Keratitis in Rabbits . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2119.
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Purpose: Acute bacterial keratitis is a sight-threatening condition that demands prompt diagnosis and effective therapy. Moxifloxacin, a newer fourth generation ophthalmic fluoroquinolone, has an expanded spectrum of activity including gram positive species, while maintaining excellent gram negative activity. We compared the efficacy of topical moxifloxacin versus other antibiotics and balanced saline solution (BSS) against experimental keratitis due to Streptococcus pneumoniae and Pseudomonas aeruginosa keratitis in rabbits. Methods: New Zealand white rabbits were randomly divided in two experimental groups: Pneumococcal keratitis and Pseudomonas keratitis. Each group was divided in four subgroups (Pseudomonas keratitis study: control (BSS), ofloxacin, tobramycin, and moxifloxacin; Pneumococcal keratitis study: control (BSS), ofloxacin, penicillin G, and moxifloxacin) to compare the drug efficacy with other antibiotic agents and control. Bacterial keratitis models were created with the central corneal intrastromal injection of a 100 ul suspension containing 1 X 106 organisms. After the development of infection, topical eye drops were applied onto the affected right eyes every 1 hour for 12 hours. The animals were sacrificed one hour after administration of the last antibiotic drop, corneal buttons were excised and homogenized prior to quantitative bacteriologic analysis after 24 hours incubation at 37°C. Results: All three antibiotic treatment groups in both studies had significant decreases in the number of CFU/cornea compared with the control groups. Eyes treated with moxifloxacin had fewer CFU/cornea of Streptococcus pneumoniae than ofloxacin-treated eyes and similar CFU/cornea to penicillinG -treated eyes. Eyes treated with moxifloxacin also had fewer CFU/cornea of Pseudomonas aeruginosa than ofloxacin- or tobramycin-treated eyes . Conclusions: These data demonstrate the excellent in vivo activity of topical moxifloxacin against keratitis due to Streptococcus pneumoniae and Pseudomonas aeruginosa in rabbits. Moxifloxacin is a promising new agent for consideration of initial broad spectrum empiric therapy of bacterial keratitis.
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