Abstract
Purpose::
Patients presenting with bacterial eyelid infections are treated empirically while waiting for culture and sensitivity results. The incidence of community-acquired methacillin-resistant Staphylococcus aureus has more than doubled since the 1980’s, raising the question of which medication should be used for this empiric treatment at first presentation.
Methods::
Microbiology specimens for eyelid cultures were reviewed from January 2000 through November 15, 2006 at the Bascom Palmer Eye Institute. The percent sensitivity of all organisms was evaluated for Ampicillin/Sulbactam, Cefazolin, Ciprofloxacin, Gentamicin, Trimethoprim/Sulfamethoxazole, and Vancomycin.
Results::
All gram positive isolates accounted for 74.5%, whereas gram negative organisms accounted for 25.5%. Staphylococcus aureus was the most common isolate (56.8%), with methacillin-resistance found in 35% of these cases. Against all isolates, the percent of organisms sensitive to the antibiotics were: Ampicillin/Sulbactam 57.9%, Cefazolin 58.5%, Ciprofloxacin 85.4%, Gentamicin 95.8%, Trimethoprim/Sulfamethoxazole 98.3%. Vancomycin was 99% sensitive for S. aureus and not measured for the gram negative organisms.
Conclusions::
With the rise in community-acquired MRSA, the efficacy of beta-lactam-based antibiotics is decreasing. Trimethoprim/Sulfamethoxazole shows high bacterial sensitivity with easy twice-daily dosing and should be considered in first-line empiric treatment of eyelid infections.
Keywords: antibiotics/antifungals/antiparasitics • eyelid • microbial pathogenesis: clinical studies