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2004
OMIG, Abstract 10
OMIG
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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.
OMIG
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