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2003
OMIG, Abstract 11
OMIG
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The
Prevention of Bacterial Endophthalmitis By Topical Moxifloxacin
in a Rabbit Prophylaxis Model
R.P. Kowalski, E.G. Romanowski, F.S. Mah, K Yates, and Y.J. Gordon.
The Charles T. Campbell Laboratory at the University of Pittsburgh,
Pittsburgh, PA.
Purpose:
We evaluated the prophylactic potential of the topical antibiotic,
moxifloxacin, to prevent endophthalmitis following bacterial anterior
chamber challenge in a NZW rabbit prophylaxis model..
Methods: Using an IACUC approved protocol, 10 rabbits
were administered one drop of 0.5% moxifloxacin every 15 minutes
for one hour (5 drops) to the left eye and similarly 10 rabbits
were administered saline immediately prior to bacterial inoculation.
The anterior chambers of the 20 rabbits were injected with 0.025
ml of broth containing approximately 5 x 104 colony forming units
of a clinical endophthalmitis isolate of Staphylococcus aureus.
The moxifloxacin treated eyes were immediately administered another
drop of moxifloxacin and 4 more drops were applied over the next
24 hours. The saline treated eyes were given the same treatment
regimen with saline. At 24 hours post injection, the eyes were evaluated
by slit-lamp in a masked fashion for the presence of iritis, hypopyon,
conjunctival/scleral injection, limbal injection, corneal infiltration,
blepharitis, AC cells, AC flare, red reflex, and fibrin using a
scale of 0, 0.5, 1, 2, and 3 based on increasing severity. After
sacrifice, the anterior and posterior chambers were cultured for
bacteria. All data were analyzed with the Kruskal-Wallis test.
Results: The clinical scores of endophthalmitis
were significantly (p=0.0001) more severe for the saline treated
group (median=21.5) than the moxifloxacin treated group (median=0.0),
which demonstrated no signs of endophthalmitis. The anterior and
posterior chambers were negative for Staphylococcus aureus in the
moxifloxacin group, but 50% (5/10) (mox vs saline, p=0.03) of the
anterior chambers and 30% (3/10) (mox vs saline, p=0.21) of the
posterior chambers were positive in the saline group. The median
log transformed colony count from the anterior chamber of the saline
group (1.35) was significantly higher (p=0.013) than the moxifloxacin
group (zero colonies).
Conclusions: In our rabbit model, we demonstrated
a proof of principle, that topical antibiotic therapy pre- and post
intraocular bacterial challenge could prevent bacterial endophthalmitis.
Surgical prophylaxis with topical moxifloxacin (0.5%) may prove
to be a valuable adjunct for the prevention of endophthalmitis.
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