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Comparison of one-day versus one-hour application of topical gatifloxacin in eliminating conjunctival bacterial flora.

Abstract：

PURPOSE:To compare efficacies of 1-day, 1-hour, and combined 1-day/1-hour preoperative topical gatifloxacin in eliminating conjunctival bacterial flora. DESIGN:Prospective, comparative case series. PARTICIPANTS:Sixty patients (120 eyes) scheduled to undergo anterior segment intraocular surgery at Stanford University Medical Center. METHODS:Cultures were collected from the palpebral conjunctival sac at baseline and after 1 day (4 doses), 1 hour (3 doses), and 1 day/1 hour (7 doses) of gatifloxacin use. MAIN OUTCOME MEASURES:Incidence of positive bacterial samples collected pre- and post-antibiotic treatment and number of colony forming units (CFUs). RESULTS:SeptiChek (Becton Dickinson, Franklin Lakes, NJ) positive cultures significantly decreased from 67% growth at baseline to 28% (P<0.0001) after 1 day and from 60% at baseline to 37% (P = 0.018) after 1 hour of gatifloxacin use. Reductions of 44% growth at baseline to 12% (P = 0.0001) after 1 day and 32% at baseline to 13% (P = 0.029) after 1 hour of gatifloxacin use were observed on blood agar. Surgical eyes that received both 1-day and 1-hour preoperative gatifloxacin had reductions from 67% growth at baseline to 18% posttreatment (P<0.0001) and 45% at baseline to 7% posttreatment (P<0.0001) on SeptiChek and blood agar media, respectively. In addition to a lower frequency of positive cultures, a significantly lower CFU count was found after 1-day (P = 0.004) and 1-hour (P = 0.049) gatifloxacin use compared with pretreatment levels. Combined 1-day/1-hour doses of gatifloxacin were associated with a greater reduction in CFUs (P = 0.001) when compared with 1-hour treatment alone. CONCLUSIONS:Both 1-hour and 1-day topical gatifloxacin use are effective in reducing the frequency of conjunctival bacterial growth and the overall bacterial load as measured by CFUs, relative to baseline. Although a 1-hour pretreatment is associated with a reduction in bacterial growth, the combination of 1-day and 1-hour preoperative gatifloxacin dosing results in an even lower overall bacterial load, suggesting that the latter might be the preferred preoperative regimen for eyes undergoing anterior segment surgery.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Moss JM,Nguyen D,Liu YI,Singh K,Montague A,Egbert PR,Kaspar HM,Ta CN

doi

10.1016/j.ophtha.2008.06.024

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

2013-6

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(08)00637-4

journal_volume

115

pub_type

临床试验,杂志文章

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Comparison of one-day versus one-hour application of topical gatifloxacin in eliminating conjunctival bacterial flora.