A prospective randomized study to determine the efficacy of preoperative topical levofloxacin in reducing conjunctival bacterial flora.
OBJECTIVE
To compare the efficacy of topical levofloxacin in combination with povidone-iodine irrigation vs povidone-iodine (PVI) alone in reducing conjunctival bacteria.


METHODS
Prospective, randomized, controlled trial.


METHODS
One hundred and forty eyes of 140 patients scheduled to undergo intraocular surgery eyes were randomized to either group 1 or 2 (70 each). Whereas group 1 eyes had no prophylactic antibiotic, eyes in group 2 received topical treatment with one drop of 0.5% levofloxacin four times on the day before surgery. Both groups underwent irrigation of the fornices with 1% PVI. Conjunctival swabs were inoculated on solid and broth culture media to determine bacterial growth.


RESULTS
Of 132 eyes evaluated, baseline culture analysis in thioglycolate demonstrated positive culture results in 55 (84.6%) of 65 eyes from group 1, similar to 55 (82.1%) of 67 eyes in group 2 (P = .697). Before surgery, 57 (87.7%) of 65 eyes in group 1 had positive culture results, compared with 50 (74.6%) of 67 eyes in group 2 (P = .055). After irrigation with PVI, 20 (30.8 %) of 65 eyes in group 1 had positive culture results, compared with only eight (11.9%) of 67 eyes in group 2 (P = .008). After surgery, 15 (23.1%) of 65 eyes in group 1 and six (9.0%) of 67 eyes in group 2 had positive culture results (P = .027).


CONCLUSIONS
Our study shows an enhanced effect of using topical levofloxacin in combination with PVI irrigation to reduce conjunctival bacteria in patients undergoing intraocular surgery.
Miño de Kaspar
Herminia
H
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
Kreutzer
Thomas C
TC
Aguirre-Romo
Israel
I
Ta
Christopher N
CN
Dudichum
Julia
J
Bayrhof
Markus
M
Klauss
Volker
V
Kampik
Anselm
A
D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002387:Cataract Extraction; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000187:drug effects* / Q000382:microbiology*; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000517:prevention & control; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D015948:Keratoplasty, Penetrating; D064704:Levofloxacin; D008297:Male; D015242:Ofloxacin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control; D011206:Povidone-Iodine / Q000008:administration & dosage; D011446:Prospective Studies; D016896:Treatment Outcome; D014821:Vitrectomy
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D064704:Levofloxacin; D011206:Povidone-Iodine; D015242:Ofloxacin