Abstract
Abstract: :
Purpose: Increase in ciprofloxacin resistance among coagulase–negative staphylococci (CNS) recovered from vitreous and anterior chamber endophthalmitis isolates at our institution has tripled from the initial 5 years (1990–1994, 15%) after the introduction of ciprofloxacin to the current 5–year period (1999–2003, 49%). The fourth generation fluoroquinolones are predicted to provide increased coverage for CNS isolates. Methods: E–tests and disc diffusion methods were used to compare susceptibility patterns for 96 CNS isolates against ciprofloxacin, ofloxacin, levofloxacin, moxiflocacin and gatifloxacin against endophthalmitis isolates recovered between 1990 and 2003. Results: Percent of organisms susceptible are (in descending order): gatifloxacin–79%, moxifloxacin–76%, levofloxacin–69%, and ofloxacin and ciprofloxacin–66%. Over 60% of the CNS isolates resistant to ciprofloxacin (N=32) were also resistant to moxifloxacin (69%) and gatifloxacin (62%). Greater than 90% of the ciprofloxacin resistant isolates were also resistant to ofloxacin (97%) and levofloxacin (91%). Conclusions: The new fluoroquinolones may not offer expanded coverage for ciprofloxacin resistant CNS isolates. Since CNS are the most common cause of postoperative endophthalmitis, the fluoroquinolones may not offer ideal endophthalmitis prophylaxis for intraocular surgery.
Keywords: endophthalmitis • antibiotics/antifungals/antiparasitics • Staphylococcus