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2002 Ocular Microbiology and Immunology Group, Abstract 1

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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).


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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