Are Second Generation Fluroquinolone Antibiotics Losing There Competitive Edge in Precataract Surgery Prophylaxis?

Abstract

Abstract: : Purpose: To assess the change in in-vitro susceptibility patterns of endophthalmitis isolates over a ten year period.Methods: 278 isolates from endophthalmitis cases archived at the New York Eye and Ear Infirmary between 1991-2000 were retrospectively reviewed. Susceptibility data for each organism was tabulated against ciprofloxacin and gentamicin antibiotics in two 5 year periods (191-1995;1996-2000). 142 isolates were identified between 1991-1995. 136 isolates were identified between 1996-2000. Results: 73% (104) isolates were sensitive to ciprofloxacin between 1991-1995 and 57% (77) of the isolates were sensitive to ciprofloxacin between 1996-2000. 61% (86) of the isolates were sensitive to gentamicin in the period from 1991-1995 and 78% (107) were sensitive to gentamicin between 1996-2000. There is a statistically significant decrease in susceptibility of these endophthalmitis organisms to ciprofloxacin between 1991-1995 as compared to 1996-2000 (p< 0.0036). Conclusion: Commonly occuring ophthlamic microbial organisms which cause endophthalmitis are developing increasing in vitro resistance to currently available second generation fluoroquinolone antibiotics. Precataract prophylaxis with newer antimicrobials such as fourth generation fluoroquinolones (i.e. moxifloxacin) or a return to older mainstay antibiotics (aminoglycosides) should be further investigated.

Keywords: 319 antibiotics/antifungals/antiparasitics • 354 clinical (human) or epidemiologic studies: prevalence/incidence • 398 endophthalmitis