A prospective study determining the efficacy of topical 0.5% levofloxacin on bacterial flora of patients with chronic blepharoconjunctivitis.
BACKGROUND
To determine the efficacy of conjunctival bacterial eradication following a 1-day, 3-day and 7-day application of topical 0.5% levofloxacin, with and without eyelid scrub, in patients with chronic blepharoconjunctivitis (CBC).


METHODS
Patients with CBC (n = 60) were prospectively randomized to three groups (n = 20 in each group): no antibiotic treatment, topical levofloxacin four times per day in both eyes, and eyelid scrub in addition to topical levovofloxacin four times a day in both eyes. Patients without CBC (n = 40) were enrolled as the negative control group. Cultures of the conjunctiva were obtained from both eyes at baseline, 1 day, 3 days, and 7 days following treatment.


RESULTS
The most common bacteria isolated for all groups at baseline were coagulase-negative Staphylococcus. Eight patients did not complete the study. The remaining 52 patients with CBC had a significantly higher rate of positive thioglycolate broth cultures (94%) compared to a 58% positive culture rate in patient without CBC (P < 0.0001). Treatment with at least 3 days of topical antibiotic in patient with CBC resulted in a significant reduction (P < 0.05) in the number of thioglycolate positive cultures (<or= 60%) compared to non-treated eyes (>or= 88%). Following a minimum of a 1-day application of antibiotic, the median colony-forming unit was 0-1 compared to 3-8 for eyes without antibiotic treatment (P < 0.05). Scrubbing of the eyelids did not provide further benefit compared to antibiotic treatment alone.


CONCLUSIONS
CBC eyes have a significantly higher number of positive cultures than eyes without CBC. The application of topical 0.5% levofloxacin for at least 3 days provided a significant reduction in the number of positive cultures as well as the number of bacteria harbored on the conjunctival surface.
Yactayo-Miranda
Yazmin
Y
Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
Ta
Christopher N
CN
He
Lisa
L
Kreutzer
Thomas C
TC
Nentwich
Martin M
MM
Kampik
Anselm
A
Mino de Kaspar
Herminia
H
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001762:Blepharitis / Q000188:drug therapy*; D002908:Chronic Disease; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology; D003231:Conjunctivitis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin