Comparison of topical gatifloxacin 0.3% and ciprofloxacin 0.3% for the treatment of bacterial keratitis.
OBJECTIVE
To compare the bacteriologic and clinical efficacy of gatifloxacin and ciprofloxacin for the treatment of bacterial keratitis.


METHODS
Prospective, randomized clinical trial.


METHODS
A total of 104 eyes of 104 patients with bacterial keratitis seen at a tertiary eye-care center were randomized to treatment with gatifloxacin 0.3% eyedrops (GAT group, 50 eyes) or ciprofloxacin 0.3% eyedrops (CIP group, 54 eyes). Patients and the treating physician were masked to the antibiotic being used. Main outcome measure studied was healing of the ulcer. Patients lost to follow-up before complete healing were excluded from further analysis.


RESULTS
A significantly higher proportion of ulcers in the GAT group exhibited complete healing compared with those in the CIP group (39 eyes [95.1%] vs 38 [80.9%]; P=.042). Gatifloxacin demonstrated a significantly better action than ciprofloxacin against gram-positive cocci in vitro (P<.001), and the percentage of ulcers caused by these pathogens that healed in the GAT group was significantly better than in the CIP group (P=.009). Mean time taken for healing of ulcer and the efficacy against gram-negative bacteria did not significantly differ between the two groups.


CONCLUSIONS
Gatifloxacin had a significantly better action against gram-positive cocci both in vitro and in vivo when compared with ciprofloxacin. In view of these organisms being the leading cause of keratitis worldwide, gatifloxacin may be a preferred alternative to ciprofloxacin as the first-line monotherapy in bacterial keratitis.
Parmar
Pragya
P
Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirapalli, India.
Salman
Amjad
A
Kalavathy
Catti Munusamy
CM
Kaliamurthy
Jayaraman
J
Prasanth
Duraisamy Arvind
DA
Thomas
Philip Aloysius
PA
Jesudasan
Christdas Arul Nelson
CA
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D000077734:Gatifloxacin; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008828:Microbiological Techniques; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies
D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; D002939:Ciprofloxacin; D000077734:Gatifloxacin