May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Preservative Effectiveness in BAK and BAK-free Glaucoma Medications in a Clinical Setting
Author Affiliations & Notes
  • M. K. Shah
    New York Eye & Ear Infirmary, New York, New York
    Pathology & Laboratory Medicine,
  • D. C. Ritterband
    New York Eye & Ear Infirmary, New York, New York
    Department of Ophthalmology,
  • J. A. Liebmann
    Department of Ophthalmology, Manhattan Eye and Ear and New York University, New York, New York
  • S. Reddy
    New York Eye & Ear Infirmary, New York, New York
    Department of Ophthalmology,
  • J. Chelnis
    New York Eye & Ear Infirmary, New York, New York
    Department of Ophthalmology,
  • W. Perez
    New York Eye & Ear Infirmary, New York, New York
    Pathology & Laboratory Medicine,
  • N. Harizman
    New York Eye & Ear Infirmary, New York, New York
    Department of Ophthalmology,
  • J. A. Seedor
    New York Eye & Ear Infirmary, New York, New York
    Department of Ophthalmology,
  • Footnotes
    Commercial Relationships  M.K. Shah, R, R; D.C. Ritterband, R, R; J.A. Liebmann, R, R; S. Reddy, None; J. Chelnis, None; W. Perez, None; N. Harizman, None; J.A. Seedor, R, R.
  • Footnotes
    Support  Alcon Labs
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1221. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      M. K. Shah, D. C. Ritterband, J. A. Liebmann, S. Reddy, J. Chelnis, W. Perez, N. Harizman, J. A. Seedor; Preservative Effectiveness in BAK and BAK-free Glaucoma Medications in a Clinical Setting. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1221. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose: : To assess whether Travatan® Z a preservative free prostaglandin agent is at higher risk for patient contamination than BAK-containing prostaglandin analog when taken by patients at normal dosing schedules.

Methods: : 82 glaucoma patients taking Travatan® (#44) or Lumigan® (#38) were enrolled. Each patient’s current prostaglandin bottle as well as secondary preservative containing control drop (either Timoptic®,Azopt® or Cosopt®) were collected. New fresh bottles of the prostaglandin and secondary drop were dispensed on the day of the visit. However, the Travatan® patients (#44) received a new bottle of BAK-free Travatan® Z in place of Travatan®. Each patient’s new set of drops were collected 2-4 weeks later. The tips and contents of each patient’s bottles were swabbed and inoculated in thioglycolate broth. If turbidity was noted they were subcultured on appropriate media and identification was made through manual methods or using the VITEK 3.

Results: : Bacteria were recovered from the tip or contents of 9% of BAK-containing prostaglandin agents (Lumigan® and Travatan®) and from 8% of the BAK-free prostaglandin (Travatan Z®), p>0.05. Of the BAK-containing control drops (Timoptic®, Azopt®, Cosopt®), bacteria were recovered from the tips or contents of 9%. The tips or contents were positive in 1/8 Timoptic® bottles (13%), 5/42 (12%) Azopt® bottles and 10/142 (7%) Cosopt® bottles. These differences were also not statistically significant. Bottle tips were more frequently contaminated than solution in a ~6:1 ratio. Four patients contaminated all 4 bottles accounting for 16 of the 36 (44%) positive cultures.

Conclusions: : In a clinical setting, the absence of BAK did not significantly affect the patient contamination rate of the prostaglandin agents. Similar or higher contamination rates of BID or TID dosed control drops Cosopt®, Azopt® and Timoptic® points toward patient factors as the leading cause of contamination. This is also supported by the finding that 4 of 82 patients accounted for 44% of the positive cultures. Education towards proper instillation techniques should be emphasized in all patients using chronic drops. Clinicians should consider all factors (e.g., corneal health, IOP control, and dosing frequency) in determining the best product choice for their patients.

Keywords: clinical laboratory testing • microbial pathogenesis: experimental studies • drug toxicity/drug effects 
×
×

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.

×