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N. Hu, L. Espinosa, S. Sinnar, P.R. Egbert, K. Singh, H.–K.V. Ho, C.N. Ta, H. Mino de Kaspar; Topical 0.5% Moxifloxacin Significantly Reduces Pre–Operative Conjunctival Bacteria . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2782.
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Purpose: To determine the efficacy of topical 0.5% moxifloxacin given for 1 day compared with 3 days before intraocular surgery in reducing conjunctival bacterial flora. Methods: A total of 60 eyes from 59 patients scheduled to undergo intraocular surgery were enrolled in this prospective randomized study. All patients received topical 0.5% moxifloxacin (4x/day) before surgery and were assigned to either control (1–day, n = 33) or study (3–day, n = 27) groups. Conjunctival cultures were obtained before (T0 as a baseline) and after (T1) the application of topical moxifloxacin using a moistened cotton swab. The swabs were inoculated and incubated for aerobic/anaerobic bacteria at 37°C for 6 days on blood/chocolate agars and in blood culture broth. All patients received topical 0.5% moxifloxacin three times in five–minute intervals one hour before surgery in addition to a 5% povidone–iodine (PVI) flush of the conjunctiva. Conjunctival cultures, anterior chamber aqueous fluid (ACF), and cannula (CA) samples were obtained immediately before the incision was made (T3) and at the conclusion of surgery (T4). Results: At baseline, there was no difference in the percentage of positive samples between the control (75.8 %) and study (81.5%) groups (P = 0.8309). The percentages of positive T1 cultures in the control and study were 30.3% and 33.3% respectively. Both groups were statistically less positive than their baselines (P = 0.0005 control, P = 0.0008 study). However, a comparison of control and study groups at T1 showed no significant difference (P = 1.0000). Less than 13% of cultures from T3 and T4, and less than 3% of ACF, and CA culture were positive in both groups. Coagulase–negative Staphylococcus (70.2%) was the most common bacteria among the total of 114 isolated strains. Conclusions: Prophylaxis with topical 0.5% moxifloxacin significantly reduces conjunctival bacterial flora in patients undergoing intraocular surgery. A one–day application of topical 0.5% moxifloxacin before surgery appears to be as effective as a three–day application in eliminating bacteria from the conjunctiva.
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