Purpose:
To compare efficacy of 1-day, 3-days and 7-days application of topical 0.5% levofloxacin in reducing the bacterial lid-conjunctival flora in chronic blepharoconjunctivitis (CBC) patients.
Methods:
We enrolled 53 patients (n = 106 eyes) with CBC and randomized them into three groups: Group B, 21 patients (n = 42 eyes) did not receive any antibiotics and served as positive control. Seventeen patients (n = 34 eyes) in Group C as well as 15 patients (n = 30 eyes) in Group D received one drop of 0.5% levofloxacin four-times daily for seven days. Patients in Group D additionally were instructed to perform a scrub of their lid margins with a moistened cotton wool tip twice a day. As a negative control 40 patients (n = 80 eyes) without eye infection or antibiotic treatment were assigned to Group A. Lid and conjunctival smears were collected from all eyes and inoculated on blood-chocolate agars and thioglycolate broth for bacterial growth at specific time-points: T0: Baseline, without prior antibiotic treatment. For patients in Groups B, C and D additional cultures were collected: T1, T2, T3 after one, three and seven days respectively.
Results:
Thioglycolate broth results are shown in Table 1. The number of bacteria in Group A on blood and chocolate agar were significantly fewer in comparison to Groups B, C and D ( P = <.0001, P = <.0001,P = <.0001) respectively. The most commonly isolated bacteria was S. epidermidis (70.3%) and S. aureus and P. acnes (6.7%).
Conclusions:
There was a significant decrease in number of eyes positive for bacteria and the bacterial load on the eyes of patients that received antibiotic treatment versus those who did not. Therefore we recommend that patients with CBC be treated with antibiotics for a minimum 3 days before undergoing to intraocular surgery.
Clinical Trial:
EudraCT 2006-005075-18
Keywords: conjunctiva • eyelid • bacterial disease