gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Topical Ofloxacin prophylaxis and the selection of Fluoroquinolone-resistant conjunctival coagulase negative staphylococcus

Meeting Abstract

  • corresponding author H. Miño de Kaspar - Department of Ophthalmology, School of Medicine, Stanford University, Stanford, USA; Augenklinik der Ludwig-Maximilians Universität, München
  • T.C. Kreutzer - Augenklinik der Ludwig-Maximilians Universität, München
  • L. He - Department of Ophthalmology, School of Medicine, Stanford University, Stanford, USA
  • E.V. Nguyen - Department of Ophthalmology, School of Medicine, Stanford University, Stanford, USA
  • M.S. Blumenkranz - Department of Ophthalmology, School of Medicine, Stanford University, Stanford, USA
  • C.N. Ta - Department of Ophthalmology, School of Medicine, Stanford University, Stanford, USA

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 204

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog695.shtml

Veröffentlicht: 22. September 2004

© 2004 Miño de Kaspar et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

To determine if a prophylactic regime of 0.3% topical ofloxacin administered to patients three days prior to intraocular surgery increases the selection of resistant bacteria as opposed to a one hour application.

Methods

173 patients (185 eyes) scheduled for surgery agreed to participate in this study. All patients received topical 0.3% ofloxacin drops according to the group each was randomized into. The study group received 1-2 drops 4 times a day for 3 days prior to surgery, and both groups received 1-2 drops 3 times in the hour prior to surgery. The periorbital area and the conjunctival fornices were irrigated with 5% povidone-iodine (PVI) in the 5 minutes prior to surgery. Conjunctival smears were collected at T0 (baseline, 5 days prior to surgery), T1 (after 3 days of topical ofloxacin), T2 (after application of antibiotics, before iodine application), T3 (after PVI application, immediately prior to surgery), and T4 (at the conclusion of surgery). All specimens were cultured for 10 days at 35°C on blood/chocolate agar plates and blood culture broth (BLL Septicheck®). The specimens that were culture positive were then plated on Mueller-Hinton agars and antibiotic susceptibilities for Ofloxacin, Ciprofloxacin and Norfloxacin determined by the Kirby-Bauer Disk Diffusion Test (In-Vitro).

Results

179 eyes were included in the analysis of the study due to cancellations in surgery and failures to obtain necessary cultures. The positive cultures yielded over 40% coagulase negative Staphylococcus, and as they are the most common cause of infection, these bacteria were analyzed with respect to resistant to Ofloxacin, Ciprofloxacin and Norfloxacin. No significant difference could be found between the group that received ofloxacin and the one that had not at baseline (P = 0.4086) or after treatment (P = 0.3322).

Conclusions

A three day regiment of topical ofloxacin does not select for more resistant bacteria than the application of the antibiotic one hour before surgery.