Vancomycin Ophthalmic Ointment 1% for methicillin-resistant Staphylococcus aureus or methicillin-resistant Staphylococcus epidermidis infections: a case series.
OBJECTIVE
To investigate the efficacy and safety of Vancomycin Ophthalmic Ointment 1% (Toa Pharmaceutical Co., Ltd, Toyama, Japan) in patients with external ocular infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or methicillin-resistant Staphylococcus epidermidis (MRSE).


METHODS
A case series.


METHODS
This study was a multicentre, open-label, uncontrolled study in Japan approved as orphan drug status.


METHODS
Patients with MRSA or MRSE external ocular infections unresponsive to the treatment of fluoroquinolone eye drops.


METHODS
Vancomycin Ophthalmic Ointment 1% was administered four times daily.


METHODS
The subjective and objective clinical scores and bacterial cultures were collected at days 0 (baseline), 3, 7 and 14. The primary outcome was clinical response evaluation (efficacy rate) determined as complete response, partial response, no response and worsening. Secondary outcome was the eradication of the bacteria. Safety was assessed by adverse events including cases in which neither MRSA nor MRSE was detected.


RESULTS
Twenty-five cases with MRSA (20) or MRSE (5) infections were enrolled. Of these 25 cases, 4 discontinued the treatment due to the negative results for bacterial culture during screening or at baseline. Of the 21 cases with conjunctivitis (14), blepharitis (3), meibomitis (1), dacryocystitis (2) or keratitis (1), 14 (66.7%) cases were evaluated as being excellently (complete response, 2 cases) or well (partial response, 12 cases) treated. The eradication rates were 68.4% in MRSA (13 of 19 cases) and 100% in MRSE (2 of 2 cases). Ten adverse events occurred in 7 (28.0%) of 25 cases at the local administration site.


CONCLUSIONS
Vancomycin Ophthalmic Ointment 1% was considered to be useful for the treatment of intractable ocular MRSA/MRSE infections.
Department of Ophthalmology,  Kyoto Prefectural University of Medicine, Kyoto,  Japan.
Chie
C
Sotozono
Masahiko
M
Fukuda
Masao
M
Ohishi
Keiko
K
Yano
Hideki
H
Origasa
Yoshinori
Y
Saiki
Yoshikazu
Y
Shimomura
Shigeru
S
Kinoshita