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2002
Ocular Microbiology and Immunology Group, Abstract 1
OMIG
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Will
The Fourth-generation Fluoroquinolones Provide Any Advantage in
The Future Treatment of Bacterial Keratitis?
R.P. Kowalski, L.M.Karenchak, E.G. Romanowski, F.S. Mah, D.C. Ritterband*,
Y.J. Gordon. The Charles T. Campbell Lab, University of Pittsburgh,
Pittsburgh, PA, *New York Eye & Ear Infirmary, NY, NY
Purpose:
In the future there will be five topical fluoroquinolones on the
market. We compared the in vitro susceptibilities of bacterial keratitis
isolates to ciprofloxacin 2nd-G (C), ofloxacin 2nd-G (0), levofloxacin
3rd-G (L), moxifloxacin 4th-G (M), and gatifloxacin 4th-G (G).
Methods:
The MICs (µg/ml) of 177 bacterial keratitis isolates were
determined using Etests.
The bacterial susceptibilities were determined with the NCCLS standards
and were compared statistically along with the potencies (isolates
with the lowest MICs).
Results:
Bacteria,
# |
Susceptibility
|
Potency |
Saur Qr,
25 |
M>G=L=0=C
|
M>G>L>0>C |
Saur Qs,
25 |
M=G=L=0=C
|
M>G>L>C>0 |
CoagNeg
Qr, 10 |
M=G>L=0=C
|
M=G>L=0=C |
CoagNeg
Qs, 10 |
M=G=L=0=C
|
M>G>L>C>0 |
St viridans,
20 |
M=G=L>C=0
|
M>G>L>C>0 |
St pneumo,
20 |
M=G, L=C=0,M=G>0
|
M=G>L=C>0 |
Haemophilus,
10 |
C=M=G=L=0
|
C=G=L>M>0 |
Serratia,
10 |
C=M=G=L=0
|
C>M=G=L>0 |
Moraxella,
10 |
C=M=G=L=0
|
C=G>M>L>0 |
P aer Qs,
25 |
C=M=G=L=0 |
C>G>L>M>0 |
P aer Qr,
12 |
are
resistant to M,G,C,L,0 |
Qr,
Qs - resistant or susceptible to ciprofloxacin and ofloxacin
by disk diffusion |
Conclusions:
The 4th generation moxifloxacin and gatifloxacin demonstrated increased
potency for gram positive bacteria over levofloxacin, ciprofloxacin,
and ofloxacin, along with better in vitro susceptibility for isolates
that were 2nd and 3rd generation fluoroquinolone-resistant. The
4th generations demonstrated no advantage for gram negative coverage.
Clinical studies are needed to confirm our in vitro results.
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