July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Incidence of Polybacterial Infections in Three Bacterial Conjunctivitis Studies and Outcomes with Besifloxacin Ophthalmic Suspension 0.6%
Author Affiliations & Notes
  • Joseph M Blondeau
    Clinical Microbiology, Royal University Hospital, Saskatoon, Saskatchewan, Canada
  • Christine M Sanfilippo
    Medical Affairs, Bausch + Lomb, Rochester, New York, United States
  • Heleen H DeCory
    Medical Affairs, Bausch + Lomb, Rochester, New York, United States
  • Footnotes
    Commercial Relationships   Joseph Blondeau, None; Christine Sanfilippo, Bausch + Lomb (E); Heleen DeCory, Bausch + Lomb (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 245. doi:
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      Joseph M Blondeau, Christine M Sanfilippo, Heleen H DeCory; Incidence of Polybacterial Infections in Three Bacterial Conjunctivitis Studies and Outcomes with Besifloxacin Ophthalmic Suspension 0.6%. Invest. Ophthalmol. Vis. Sci. 2019;60(9):245.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Bacterial conjunctivitis is often a result of infection with more than one bacterial pathogen. We identified patients with polybacterial infections at baseline in clinical studies of besifloxacin ophthalmic suspension 0.6% administered three times daily for 5 days in the treatment of bacterial conjunctivitis and report on outcomes in this population.

Methods : Data from three multicenter randomized clinical studies (two vehicle- and one active-controlled) were pooled, and outcomes data for subjects with polybacterial infections at baseline were extracted for analysis. In each study, conjunctival swabs were taken at baseline and two follow-up visits (Visit 2 [days 4 or 5], and Visit 3 [days 8 or 9]). The same central laboratory was used to identify bacterial species in culture swabs. To avoid attribution of conjunctivitis to normal commensal microflora, isolates were classified as causative only if their colony count (in CFU/mL) equaled or exceeded species-specific pre-specified threshold criteria. The fold-increase in colony count over threshold was used to rank order the contribution of each causative species.

Results : Of 1041 subjects with culture-confirmed conjunctivitis across the three studies, 17% had polybacterial infections at baseline. The mean (±SD) age of these subjects was 33 (±29) years, and 56% were female; 83% were infected with two species, 15% with three, and 2% with four. Compared to subjects with monobacterial infections, a greater proportion of subjects with polybacterial infections also had viral infections (P<0.001 χ2test). Haemophilus influenzae was the most common dominant causative species in polybacterial infections followed by Staphylococcus aureus which was also the most common secondary co-infecting species. Visits 2 and 3 rates for eradication of baseline pathogens were 93% and 90% for subjects treated with besifloxacin compared with 52% and 62% for subjects treated with vehicle (P<0.001 χ2test, besifloxacin vs vehicle both visits).

Conclusions : Studies evaluating besifloxacin 0.6% for bacterial conjunctivitis included a significant number of subjects with polybacterial conjunctivitis at baseline. In this post hoc analysis, treatment with besifloxacin resulted in eradication rates that were ≥90% for these infections attesting to the broad spectrum activity of this chloro-fluoroquinolone, and required for such infections.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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