March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Increased Antibiotic Resistance Of Ocular Surface Flora After Repeated Use Of Prophylactic Topical Fluoroquinolone Post Intravitreal Injection For Neovascular Age-related Macular Degeneration (amd)
Author Affiliations & Notes
  • Vivian T. Yin
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
  • Daniel Weisbrod
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Efrem Mandelcorn
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  • Carol Schwartz
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Radha Kohly
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Ken Eng
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Wai-Ching Lam
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  • Peter Kertes
    Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada
    Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships  Vivian T. Yin, None; Daniel Weisbrod, None; Efrem Mandelcorn, Bauch and Lomb (R); Carol Schwartz, None; Radha Kohly, None; Ken Eng, None; Wai-Ching Lam, Alcon (R), Allergan (R, S), Novartis (S), Pfizer (F); Peter Kertes, Alcon (R), Allergan (R), Arctic Dx (I), Bauch and Lomb (C), Bayer/Regeneron (F, R), Novartis (F, R)
  • Footnotes
    Support  Physician Services Inc Foundation
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6269. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Vivian T. Yin, Daniel Weisbrod, Efrem Mandelcorn, Carol Schwartz, Radha Kohly, Ken Eng, Wai-Ching Lam, Peter Kertes; Increased Antibiotic Resistance Of Ocular Surface Flora After Repeated Use Of Prophylactic Topical Fluoroquinolone Post Intravitreal Injection For Neovascular Age-related Macular Degeneration (amd). Invest. Ophthalmol. Vis. Sci. 2012;53(14):6269.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : To determine if repeated use of prophylactic topical fluoroquinolone post monthly intravitreal injections for AMD will change the antibiotic resistance profile of the ocular surface flora over time.

Methods: : This was a prospective, multicenter, case-control study of patients 65 years and older with neovascular AMD undergoing treatment with monthly intravitreal injections of ranibizumab. Patients were excluded if they had active ocular or systemic infection, previously received intravitreal injections or were treated with topical or systemic antibiotics in the past three months. Patients were divided into two groups, those that received topical moxifloxacin for 3 days post injection (antibiotic group) and those that did not (no antibiotic group). Cotton tipped swabs of the inferior fornix were taken at baseline and at months 1, 2 and 3 prior to each injection. Samples were cultured and antibiotic sensitivity was recorded by MIC50 levels. The data was analyzed for differences in antibiotic resistance.

Results: : Of 177 patients included in the study, 82 received antibiotics post injections and 93 did not. The mean age was 81 years. The culture positive rate at baseline was 28.0% in the antibiotic group and 14.5% in the no antibiotic group. In the antibiotic group, the culture positive rate increased monthly to 34.7% at month 1, 38.0% at month 2 and 41.8% at month 3. In the no antibiotic group, the culture positive rate was 22.2% at month 1, 8.8% at month 2 and 22.2% at month 3. The most common organism cultured was coagulase negative staphylococcus (75%) followed by diphtheroid (22.9%), staphylococcus aureus (6.3%) and streptococcus viridians (4.9%). In the antibiotic group, there was a significant change in MIC50 for moxifloxacin from 0.105 at baseline, to 0.549 at month 1, 0.184 at month 2 and 1.184 at month 3 (p = 0.0106). In the no antibiotic group, the MIC50 for moxifloxacin was 0.439 at baseline, 0.469 at month 1, 0.0052 at month 2 and 0.687 at month 3 (p = 0.102). There were no cases of endophthalmitis.

Conclusions: : Patients treated with repeated use of topical moxifloxacin post intravitreal ranibizumab showed a significant increase in antibiotic resistance of the ocular surface flora at 3 months compared to those not given prophylactic topical antibiotics.

Clinical Trial: : http://www.clinicaltrials.gov NCT01181713

Keywords: antibiotics/antifungals/antiparasitics • injection • age-related macular degeneration 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×