A comparison of moxifloxacin and levofloxacin topical prophylaxis in a fluoroquinolone-resistant Staphylococcus aureus rabbit model.
OBJECTIVE
Moxifloxacin, a fourth-generation fluoroquinolone (FQ), was compared to levofloxacin, a third-generation FQ, for preventing FQ-resistant, methicillin-resistant Staphylococcus aureus (FQrMRSA) endophthalmitis in a rabbit model.


METHODS
Three regimens of topical treatments (moxifloxacin 0.5%, levofloxacin 0.5%, and saline) were tested to prevent endophthalmitis. For each regimen, drops were instilled every 15 min for 1 h into the left eyes of 15 rabbits. After anesthesia, 2 x 10(4) cfu of FQrMRSA was injected into the aqueous. One drop of treatment was given immediately, and another four drops were applied over 24 h. At 24 h, the eyes were clinically graded for endophthalmitis. After the rabbits were sacrificed, the aqueous and vitreous were tapped for bacterial colony counts.


RESULTS
Topical moxifloxacin (12/15, 80%) significantly (P=0.0001) prevented clinical endophthalmitis in more rabbits than levofloxacin (2/15, 13%) or saline (2/15, 13%). The total median clinical score for moxifloxacin treatment (1.0) was significantly (P=0.0004) lower than that for levofloxacin (20.0) or saline (23.0). Culture-negative eyes were less frequent for levofloxacin (8/15, 53%) and saline (1/15, 7%) treatments than for moxifloxacin treatment (12/15, 80%).


CONCLUSIONS
This in vivo study indicates that moxifloxacin, a fourth-generation FQ, may be more effective than levofloxacin, a third-generation FQ, in preventing experimental FQrMRSA. endophthalmitis.
Kowalski
Regis P
RP
The Charles T. Campbell Ophthalmic Microbiology Laboratory, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA. kowalskirp@upmc.edu.|UPMC Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. kowalskirp@upmc.edu.
Romanowski
Eric G
EG
The Charles T. Campbell Ophthalmic Microbiology Laboratory, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA.|UPMC Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Mah
Francis S
FS
The Charles T. Campbell Ophthalmic Microbiology Laboratory, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA.|UPMC Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Sasaki
Hiroshi
H
Department of Ophthalmology Division of Sensory Organ Medicine, Kanazawa Medical University, Ishikawa, Kanazawa, Japan.
Fukuda
Masamichi
M
Department of Ophthalmology Division of Sensory Organ Medicine, Kanazawa Medical University, Ishikawa, Kanazawa, Japan.
Gordon
Y J
YJ
The Charles T. Campbell Ophthalmic Microbiology Laboratory, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA.|UPMC Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
D000287:Administration, Topical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001082:Aqueous Humor / Q000382:microbiology; D001372:Aza Compounds / Q000494:pharmacology*; D015169:Colony Count, Microbial; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D024841:Fluoroquinolones / Q000494:pharmacology; D064704:Levofloxacin; D008712:Methicillin / Q000494:pharmacology; D000077266:Moxifloxacin; D015242:Ofloxacin / Q000494:pharmacology*; D011804:Quinolines / Q000494:pharmacology*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects*; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D064704:Levofloxacin; D015242:Ofloxacin; D008712:Methicillin; D000077266:Moxifloxacin