Fluoroquinolone therapy in multiple-drug resistant staphylococcal keratitis after lamellar keratectomy in a rabbit model.
OBJECTIVE
To assess the effectiveness of a fourth-generation fluoroquinolone for prophylaxis against multiple drug-resistant staphylococcal keratitis after lamellar keratectomy in a rabbit model.


METHODS
Experimental study.


METHODS
Twenty-eight New Zealand white rabbits underwent unilateral lamellar keratectomy using a manual microkeratome followed by the placement of 1000 colony-forming units (CFUs) of log-phase Staphylococcus aureus bacteria under each flap. Eyes (seven in each group) were randomized and treated with one of the following agents: sterile balanced salt solution, gatifloxacin (0.3%), ciprofloxacin (0.3%) or levofloxacin (0.5%) immediately and 6, 12, and 18 hours after surgery. Inflammation was graded by two masked observers at 24 and 48 hours, and the presence or absence of infectious infiltrates was determined. The means and standard deviations were calculated, and differences among the groups were statistically analyzed.


RESULTS
There were no flap complications encountered during surgery. Eyes treated with ciprofloxacin, levofloxacin, and balanced salt solution developed infectious infiltrates in five of seven eyes per group. Gatifloxacin-treated eyes did not develop clinical infection and exhibited lower mean inflammation scores (P <.01 compared with the other groups).


CONCLUSIONS
The fourth-generation fluoroquinolone, gatifloxacin, is an effective prophylaxis against the development of keratitis after lamellar keratectomy in rabbits with an organism resistant to methicillin, levofloxacin, and ciprofloxacin.
Tungsiripat
Tulaya
T
Department of Ophthalmology, University of California Irvine, Irvine, California 92697, USA.
Sarayba
Melvin A
MA
Kaufman
Matthew B
MB
Sweet
Paula M
PM
Taban
Mehran
M
Carpenter
Thomas R
TR
McDonnell
Peter J
PJ
D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003319:Corneal Stroma / Q000382:microbiology; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D024841:Fluoroquinolones; D000077734:Gatifloxacin; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D064704:Levofloxacin; D015242:Ofloxacin / Q000627:therapeutic use; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology; D013524:Surgical Flaps / Q000382:microbiology
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D002939:Ciprofloxacin; D064704:Levofloxacin; D015242:Ofloxacin; D000077734:Gatifloxacin