Abstract
Purpose:
To compare antibacterial efficacy of besifloxacin (BESI) versus moxifloxacin (MOXI) on ocular surface tissues after 1 hour and 3 days of treatment respectively.
Methods:
60 pts were randomized in a single center study to receive either BESI or MOXI for 3 days (QID) prior to cataract surgery in their surgical eye, and 1 hour prior to their final cultures in their non-surgical eye, on the day of surgery. Lid and conjunctival cultures were obtained prior to treatment in all eyes.
Results:
The lid cultures for the surgical eyes (3 day tx) revealed a significant decrease in colony forming units (CFU) for both BESI (4,925+/-1,830 to 315+/-8 CFU) (p=0.01) and MOXI (1,124+/- 337 to 207+/- 20 CFU)(p=0.01). However the percent of NO GROWTH lid cultures in these surgical eyes (3 day tx) for BESI increased from 13 % to 44 % pre-tx to post tx, but only from 16% to 20 % for MOXI eyes. In addition, the CFUs of the lid cultures for the non-surgical eyes (1hr tx) decreased significantly in the BESI eyes (3,217+/-1,022 to 558+/-377 CFU) (p=0.02) but INCREASED for the MOXI eyes (1,781+/-325 to 2,268+/-897 CFU)(p=0.55). The percent of NO GROWTH lid cultures in these non-surgical eyes (3 day tx) for BESI increased significantly from 10% to 52% pre-tx to post tx, but decreased in the MOXI eyes from 10% to 0%. The conjunctival cultures also revealed similar results with greater decreases in CFUs favoring BESI vs. MOXI in the non surgical (1 hr tx) eyes, but statistical significance was not reached due to smaller CFUs and large statistical variances. The mean CFU in MRSE BESI surgical eyes (3 day tx)(n=8)(7,020 to 15)(p=0.01) and non surgical eyes (1 hr tx) (n=6) (7,961 to 633)(p=0.03) decreased significantly. The mean CFU in MRSE MOXI surgical eyes (3 day tx)(n=8)(219 to 139) showed no significant decrease (p=.051) and the non surgical eyes (1hr tx)(n=9) showed a substantial INCREASE in CFU (1,051 to 3,290).
Conclusions:
: Both BESI and MOXI revealed significant reductions in lid CFUs after 3 days of treatment. In contrast, only BESI revealed significant reductions in lid CFU after 1 hour of treatment. BESI also revealed more rapid and significant killing of MRSE. These results suggest that BESI has a significantly more rapid kill rate and is more efficacious in MRSE eyes versus MOXI in a typical population of pts undergoing cataract surgery.
Keywords: 422 antibiotics/antifungals/antiparasitics •
716 small incision cataract surgery •
427 aqueous