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Integrated analysis of three bacterial conjunctivitis trials of besifloxacin ophthalmic suspension, 0.6%: etiology of bacterial conjunctivitis and antibacterial susceptibility profile.

Haas W, Gearinger LS, Usner DW, Decory HH, Morris TW - Clin Ophthalmol (2011)

Bottom Line: Against ciprofloxacin-resistant MRSA and MRSE, besifloxacin was four-fold to ≥ 128-fold more potent than other fluoroquinolones.Patient age and local antibiotic resistance trends should be considered in the treatment of this ocular infection.Besifloxacin showed broad-spectrum in vitro activity and was particularly potent against multidrug-resistant staphylococcal isolates.

View Article: PubMed Central - PubMed

Affiliation: Microbiology and Sterilization Sciences, Bausch and Lomb Inc, Rochester, NY, USA.

ABSTRACT

Background: The purpose of this paper is to report on the bacterial species isolated from patients with bacterial conjunctivitis participating in three clinical trials of besifloxacin ophthalmic suspension, 0.6%, and their in vitro antibacterial susceptibility profiles.

Methods: Microbial data from three clinical studies, conducted at multiple clinical sites in the US and Asia were integrated. Species were identified at a central laboratory, and minimum inhibitory concentrations were determined for various antibiotics, including β-lactams, fluoroquinolones, and macrolides.

Results: A total of 1324 bacterial pathogens representing more than 70 species were isolated. The most common species were Haemophilus influenzae (26.0%), Streptococcus pneumoniae (22.8%), Staphylococcus aureus (14.4%), and Staphylococcus epidermidis (8.4%). H. influenzae was most frequently isolated among patients aged 1-18 years, while S. aureus was most prevalent among those >65 years. Drug resistance was prevalent: Of H. influenzae isolates, 25.3% were β-lactamase positive and 27.2% of S. pneumoniae isolates were penicillin-intermediate/ resistant; of S. aureus isolates, 13.7% were methicillin-resistant (MRSA), and of these, 65.4% were ciprofloxacin-resistant, while 45.9% of S. epidermidis isolates were methicillin-resistant (MRSE), and, of these, 47.1% were ciprofloxacin-resistant. Besifloxacin was more potent than comparator fluoroquinolones overall, and particularly against Gram-positive bacteria. Against ciprofloxacin-resistant MRSA and MRSE, besifloxacin was four-fold to ≥ 128-fold more potent than other fluoroquinolones.

Conclusions: While the pathogen distribution in bacterial conjunctivitis has not changed, drug resistance is increasing. Patient age and local antibiotic resistance trends should be considered in the treatment of this ocular infection. Besifloxacin showed broad-spectrum in vitro activity and was particularly potent against multidrug-resistant staphylococcal isolates.

No MeSH data available.


Related in: MedlinePlus

Distribution of minimum inhibitory concentrations for besifloxacin (light gray) and ciprofloxacin (dark gray) for 95 isolates from Asia.
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f3-opth-5-1369: Distribution of minimum inhibitory concentrations for besifloxacin (light gray) and ciprofloxacin (dark gray) for 95 isolates from Asia.

Mentions: Figure 3 presents the MIC distributions for besifloxacin and ciprofloxacin for all isolates obtained from patients at Asian clinical sites, which included sites in India and the Philippines. While the MIC distributions for isolates obtained from US clinical sites had a distinct peak, MIC values for isolates obtained from Asian sites were more widely distributed, and ciprofloxacin MICs ≥ 4 μg/mL were more common, indicating that isolates from Asian sites were overall more resistant to ciprofloxacin compared with isolates from US sites. The increase in ciprofloxacin MIC90 values between isolates from US and Asian sites was noted overall for Gram-positive and Gram-negative bacteria and specifically for S. aureus and H. influenzae (discussed further below).


Integrated analysis of three bacterial conjunctivitis trials of besifloxacin ophthalmic suspension, 0.6%: etiology of bacterial conjunctivitis and antibacterial susceptibility profile.

Haas W, Gearinger LS, Usner DW, Decory HH, Morris TW - Clin Ophthalmol (2011)

Distribution of minimum inhibitory concentrations for besifloxacin (light gray) and ciprofloxacin (dark gray) for 95 isolates from Asia.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198410&req=5

f3-opth-5-1369: Distribution of minimum inhibitory concentrations for besifloxacin (light gray) and ciprofloxacin (dark gray) for 95 isolates from Asia.
Mentions: Figure 3 presents the MIC distributions for besifloxacin and ciprofloxacin for all isolates obtained from patients at Asian clinical sites, which included sites in India and the Philippines. While the MIC distributions for isolates obtained from US clinical sites had a distinct peak, MIC values for isolates obtained from Asian sites were more widely distributed, and ciprofloxacin MICs ≥ 4 μg/mL were more common, indicating that isolates from Asian sites were overall more resistant to ciprofloxacin compared with isolates from US sites. The increase in ciprofloxacin MIC90 values between isolates from US and Asian sites was noted overall for Gram-positive and Gram-negative bacteria and specifically for S. aureus and H. influenzae (discussed further below).

Bottom Line: Against ciprofloxacin-resistant MRSA and MRSE, besifloxacin was four-fold to ≥ 128-fold more potent than other fluoroquinolones.Patient age and local antibiotic resistance trends should be considered in the treatment of this ocular infection.Besifloxacin showed broad-spectrum in vitro activity and was particularly potent against multidrug-resistant staphylococcal isolates.

View Article: PubMed Central - PubMed

Affiliation: Microbiology and Sterilization Sciences, Bausch and Lomb Inc, Rochester, NY, USA.

ABSTRACT

Background: The purpose of this paper is to report on the bacterial species isolated from patients with bacterial conjunctivitis participating in three clinical trials of besifloxacin ophthalmic suspension, 0.6%, and their in vitro antibacterial susceptibility profiles.

Methods: Microbial data from three clinical studies, conducted at multiple clinical sites in the US and Asia were integrated. Species were identified at a central laboratory, and minimum inhibitory concentrations were determined for various antibiotics, including β-lactams, fluoroquinolones, and macrolides.

Results: A total of 1324 bacterial pathogens representing more than 70 species were isolated. The most common species were Haemophilus influenzae (26.0%), Streptococcus pneumoniae (22.8%), Staphylococcus aureus (14.4%), and Staphylococcus epidermidis (8.4%). H. influenzae was most frequently isolated among patients aged 1-18 years, while S. aureus was most prevalent among those >65 years. Drug resistance was prevalent: Of H. influenzae isolates, 25.3% were β-lactamase positive and 27.2% of S. pneumoniae isolates were penicillin-intermediate/ resistant; of S. aureus isolates, 13.7% were methicillin-resistant (MRSA), and of these, 65.4% were ciprofloxacin-resistant, while 45.9% of S. epidermidis isolates were methicillin-resistant (MRSE), and, of these, 47.1% were ciprofloxacin-resistant. Besifloxacin was more potent than comparator fluoroquinolones overall, and particularly against Gram-positive bacteria. Against ciprofloxacin-resistant MRSA and MRSE, besifloxacin was four-fold to ≥ 128-fold more potent than other fluoroquinolones.

Conclusions: While the pathogen distribution in bacterial conjunctivitis has not changed, drug resistance is increasing. Patient age and local antibiotic resistance trends should be considered in the treatment of this ocular infection. Besifloxacin showed broad-spectrum in vitro activity and was particularly potent against multidrug-resistant staphylococcal isolates.

No MeSH data available.


Related in: MedlinePlus