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Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis.

Authors :
Ray KJ
Prajna L
Srinivasan M
Geetha M
Karpagam R
Glidden D
Oldenburg CE
Sun CQ
McLeod SD
Acharya NR
Lietman TM
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.

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