Limitations of current antibiotics for the treatment of bacterial conjunctivitis.
Bacterial conjunctivitis is a common ocular infection that is generally treated empirically with a broad-spectrum antibiotic. The more common pathogens causing bacterial conjunctivitis include Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus epidermidis, and Moraxella species. Several antibiotics traditionally used to treat bacterial conjunctivitis are no longer widely prescribed because of increased bacterial resistance and/or safety concerns. The introduction of the fluoroquinolone class of anti-infectives offered effective and better tolerated treatment options. Nonetheless, successful therapy for bacterial conjunctivitis continues to be limited by several factors. A primary concern is the development of bacterial resistance that may be impacted not only by widespread antibiotic use but also by antibacterial pharmacokinetics, such as maintenance of insufficient bactericidal concentrations at the site of infection. In addition, poor adherence to prescribed regimens that require frequent administration, along with undesirable adverse events, affects the development of bacterial resistance and the success of treatment regimens. This article reviews current antibacterial agents used to treat bacterial conjunctivitis, factors that limit their successful use in treatment, and options for future development of more effective topical ophthalmic anti-infective agents.
Karpecki
Paul
P
Koffler Vision Group, Lexington, Kentucky 40509, USA. paul@karpecki.com
Paterno
Michael R
MR
Comstock
Timothy L
TL
D000617:Aminoglycosides / Q000009:adverse effects / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000493:pharmacokinetics; D000891:Anti-Infective Agents, Local / Q000009:adverse effects / Q000493:pharmacokinetics; D001548:Benzalkonium Compounds / Q000009:adverse effects / Q000493:pharmacokinetics; D003234:Conjunctivitis, Bacterial / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology; D004338:Drug Combinations; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D018942:Macrolides / Q000009:adverse effects / Q000493:pharmacokinetics; D009994:Osmolar Concentration; D010349:Patient Compliance
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D004338:Drug Combinations; D024841:Fluoroquinolones; D018942:Macrolides