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2004 OMIG, Abstract 10

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Clinical Diagnosis, Isolate Frequency, and Susceptibility Profiles for Community Patients Pretreated with 4th Generation Fluoroquinolones
D Miller, E Alfonso, M Diaz, E Perez. Bascom Palmer Eye Institute, Miami, Florida

Purpose: To document clinical diagnosis, isolate frequency and susceptibility patterns for patients presenting on 4th generation fluoroquinolones.
Methods: Culture results for 104 patients pretreated with moxifloxacin and or gatifloxacin were reviewed and analyzed for clinical diagnosis, pathogen frequency and susceptibility profiles.
Results: Fifty five percent of patients were pretreated with moxifloxacin vs 43% for gatifloxacin, the remaining two patients were treated with a combination of both drugs. Keratitis (86%) was the most frequent clinical indication followed by intraocular infections (7%), conjunctivitis (5%) and 2% in other soft tissue infections. Seventy-one per cent of collected cultures did not grow. There was no significant difference (p =0.73, 95 CI) between negative cultures for moxifloxacin (72%) and gatifloxacin (69%). Fungi, Nocardia and Acanthamoeba were recovered singularly or in combination in 47% (n=14) of culture positive patients (N=30). Fungi and acanthamoeba were more frequently recovered from patients presenting on moxifloxain (50%) than gatifloxacin (19%). Gram negative and gram positive isolates constituted 53% of the isolates. Multiple isolates were documented in 4 (13%) of the 30 culture positive patients. S. aureus (4) and S. epidermidis (3) were the most common gram positive pathogens. P. aeruginosa was the most frequent gram negative isolate (4). General bacterial susceptibility was 94% for moxifloxacin and 92% for gatifloxacin.
Conclusion: 4th generation fluoroquinolones were used to treated a variety of ocular infections in the South Florida community. Nonbacterial pathogens were the most frequently recovered microorganisms in patients presenting on these drugs. Coverage for bacterial pathogens was less than 95% for both drugs.

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