title: Efficacy of tobramycin drops applied to collagen shields for experimental staphylococcal keratitis.
abstract: Treatment of staphylococcal keratitis includes tobramycin drops at repeated intervals, a prolonged therapy that is disruptive to the patient. To identify a regimen involving less frequent drug application, we compared the efficacy of fortified tobramycin (1.36%) administered by collagen shields or in topical drop form to rabbit corneas intrastromally infected with staphylococci. Eyes were treated with shields hydrated in and supplemented with fortified tobramycin drops (1.36%) applied every 1, 2, 5, or 10 h, from 10 to 20 h postinfection. For topical drop treatment alone, tobramycin was applied following the identical regimen. Untreated corneas contained 10(6) colony forming units. Shields supplemented with tobramycin drops applied every 1, 2, or 5 h sterilized 100% of the corneas. Shields supplemented with tobramycin drops applied at 10 h sterilized 58% of the corneas. Topical delivery of tobramycin every h sterilized all corneas; drops alone applied at longer intervals, such as 2, 5, or 10 h, sterilized 83%, 17%, and 0% of the corneas, respectively. Collagen shield delivery of tobramycin with supplemental topical drops can eradicate staphylococci in this model with less frequent dosing intervals than are required with topical therapy alone.
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Louisiana State University Medical Center School of Medicine, New Orleans 70112.
authors.forename: M C
authors.initials: MC
authors.lastname: Callegan
authors.forename: L S
authors.initials: LS
authors.lastname: Engel
authors.forename: T E
authors.initials: TE
authors.lastname: Clinch
authors.forename: J M
authors.initials: JM
authors.lastname: Hill
authors.forename: H E
authors.initials: HE
authors.lastname: Kaufman
authors.forename: R J
authors.initials: RJ
authors.lastname: O'Callaghan
mesh_terms: D000287:Administration, Topical; D000818:Animals; D003094:Collagen; D015169:Colony Count, Microbial; D003315:Cornea / Q000187:drug effects / Q000382:microbiology; D016503:Drug Delivery Systems; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D009883:Ophthalmic Solutions; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects; D014031:Tobramycin / Q000008:administration & dosage*
chemical_list: D009883:Ophthalmic Solutions; D003094:Collagen; D014031:Tobramycin