Back to Search
Start Over
Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis.
- Source :
-
JAMA ophthalmology [JAMA Ophthalmol] 2013 Mar; Vol. 131 (3), pp. 310-3. - Publication Year :
- 2013
-
Abstract
- Objective: To analyze the relationship between fluoroquinolone use at presentation and minimum inhibitory concentration in bacterial keratitis.<br />Methods: The Steroids for Corneal Ulcers Trial was a randomized, double-masked, placebo-controlled trial assessing the effect of adjunctive topical corticosteroid treatment on outcomes in bacterial keratitis. After presentation, all patients were treated with moxifloxacin hydrochloride, 0.5%. We compare antibiotic use at presentation with minimum inhibitory concentration against moxifloxacin for all isolates. Separate analyses accounted for organism species and fluoroquinolone generation.<br />Results: Topical fluoroquinolone use at presentation was reported in 92 of 480 cases (19.2%). Causative organisms in the 480 cases included Streptococcus pneumoniae (247 cases [51.5%]), Pseudomonas aeruginosa (109 cases [22.7%]), and Nocardia species (55 cases [11.5%]). Isolates from patients who reported fluoroquinolone use at presentation had a 2.01-fold-higher minimum inhibitory concentration (95% CI, 1.39-fold to 2.91-fold; P < .001). Fourth-generation fluoroquinolones were associated with a 3.48-fold-higher minimum inhibitory concentration than those isolates that were not exposed to pretreatment at enrollment (95% CI, 1.99-fold to 6.06-fold; P < .001).<br />Conclusion: This study provides evidence that prior use of fluoroquinolones is associated with antibiotic resistance.<br />Trial Registration: clinicaltrials.gov Identifier: NCT00324168.
- Subjects :
- Adult
Corneal Ulcer drug therapy
Double-Blind Method
Eye Infections, Bacterial drug therapy
Female
Fluoroquinolones
Glucocorticoids therapeutic use
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Moxifloxacin
Nocardia drug effects
Nocardia Infections drug therapy
Nocardia Infections microbiology
Pneumococcal Infections drug therapy
Pneumococcal Infections microbiology
Prednisolone analogs & derivatives
Prednisolone therapeutic use
Pseudomonas Infections drug therapy
Pseudomonas Infections microbiology
Pseudomonas aeruginosa drug effects
Streptococcus pneumoniae drug effects
Anti-Bacterial Agents therapeutic use
Aza Compounds therapeutic use
Bacteria drug effects
Corneal Ulcer microbiology
Drug Resistance, Bacterial
Eye Infections, Bacterial microbiology
Quinolines therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2168-6173
- Volume :
- 131
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- JAMA ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 23307105
- Full Text :
- https://doi.org/10.1001/jamaophthalmol.2013.1718