title: Evaluation of 0.3% gatifloxacin hydrochloride in decontamination of donor corneas.
abstract: OBJECTIVE
  To evaluate demographic, clinical, and microbiological profile of eye donors and efficacy of 0.3% gatifloxacin hydrochloride in microbial decontamination of donor corneas.
  
  
  METHODS
  About 513 donors and 1,026 corneas received at National Eye Bank of a tertiary care hospital during 1-year period were analyzed prospectively in this randomized clinical trial. The donor eyes were graded and treated with 5% povidone-iodine, 0.4% amikacin sulphate, and 0.3% gatifloxacin hydrochloride. The parameters evaluated were death enucleation time (DET), grading of donor corneas, microbiological profile of culture organisms, and their sensitivity to various antibiotics.
  
  
  RESULTS
  Mean DET was 6.29±5.7 hours. Forty one percent eyes were optical grade corneas and the majority of donors (38.5%) had accidental deaths. Good grade eyes were maximum with DET of <1 hour and were comparable between 0-6 hours and 6-12 hours. About 57.6% (591/1026) eyes were culture positive; most common organisms were Pseudomonas spp (53%) and Coagulase-negative Staphylococci (24%). Culture positivity reduced significantly after treatment with povidone iodine and amikacin (P=0.002, right eye; P=0.004; left eye) and decreased further with use of gatifloxacin (P=0.001). Pseudomonas (93%), Coagulase-negative Staphylococci (96.3%), Staphylococcus aureus (90.5%), enterococci and gram-negative bacilli were sensitive to gatifloxacin. Pseudomonas spp which were multidrug-resistant were sensitive to polymyxin-B.
  
  
  CONCLUSIONS
  Gatifloxacin hydrochloride in addition to amikacin sulphate is beneficial for donor eye decontamination. Polymyxin-B may be used for multidrug-resistant Pseudomonas spp.
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. namrata.sharma@gmail.com
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Amarendra
authors.initials: A
authors.lastname: Samal
authors.forename: Reena
authors.initials: R
authors.lastname: Sharma
authors.forename: Radhika
authors.initials: R
authors.lastname: Tandon
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
authors.forename: Gita
authors.initials: G
authors.lastname: Satpathy
authors.forename: Seema
authors.initials: S
authors.lastname: Sen
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000737:chemistry / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000187:drug effects / Q000382:microbiology*; D004203:Disinfection / Q000379:methods*; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000737:chemistry / Q000494:pharmacology*; D000077734:Gatifloxacin; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011206:Povidone-Iodine / Q000494:pharmacology; D011446:Prospective Studies; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D000583:Amikacin; D011206:Povidone-Iodine; D000077734:Gatifloxacin