Abstract
Purpose::
To assess the correlation of in vitro efficacy with the cost of commonly used ocular antibiotics.
Methods::
1161 bacterial conjunctivitis isolates collected between 1993 and 2005 in Campbell Laboratory, Pittsburgh, Pennsylvania, were tested for in vitro susceptibility to 11 commonly used ocular antibiotics. The average cost of each antibiotic was obtained by surveying 6 national pharmacy chains.
Results::
The percentages of susceptible isolates and the average costs of the antibiotics were: moxifloxacin (86%, $73.38), ofloxacin (86%, $46.75), ciprofloxacin (84%, $49.18), gatifloxacin (84%, $70.38), sulfacetamide (84%, $13.11), polymyxin B/trimethoprim (polytrim): (80%, $22.18), gentamicin (74%, $14.68), bacitracin (70%, $10.82), tobramycin (68%, $15.13), and erythromycin (62%, $11.17).
Conclusions::
Amongst the tested agents, sulfacetamide (a bacteriostatic antibiotic) with 84% in vitro coverage of all the isolates and an average cost of $13.11 appeared to be the most cost-effective antibiotic for empirical coverage of bacterial conjunctivitis. Although more expensive, the fluoroquinolones (bacteriocidal) appeared to provide similar coverage. Clinical experience should dictate a physician's choice of antibiotics to treat bacterial conjunctivitis.
Keywords: bacterial disease • conjunctivitis • antibiotics/antifungals/antiparasitics