title: The role of besifloxacin in the treatment of bacterial conjunctivitis.
abstract: OBJECTIVE
  To evaluate the role of besifloxacin in bacterial conjunctivitis treatment.
  
  
  METHODS
  Searches were made on MEDLINE/PubMed and EMBASE (January 2007 to January 2014) using the terms besifloxacin and Besivance. References from these publications were reviewed for additional resources. Additional information was collected from Bausch & Lomb, the manufacturer of Besivance; www.clinicaltrials.gov; and American Academy of Ophthalmology.
  
  
  METHODS
  English-language documents were reviewed for pharmacology, pharmacokinetics, efficacy, and safety, with priority on clinical trials.
  
  
  RESULTS
  Three large randomized controlled clinical trials established the safety and efficacy of besifloxacin ophthalmic suspension 0.6% compared with placebo or active comparator (moxifloxacin ophthalmic solution 0.5%) given 3 times a day for 5 days for acute bacterial conjunctivitis (BC) treatment. Compared with placebo, besifloxacin had clinically superior bacterial eradication rates and was noninferior to moxifloxacin. Besifloxacin was compared with placebo in 2 randomized, placebo-controlled trials, dosed twice a day for 3 days. Superior efficacy was seen compared with placebo, which supports the shorter dosing schedule. Ophthalmic besifloxacin is well tolerated; the most common adverse effect (conjunctival redness) occurred in 2% of patients. Adverse effects in 1% to 2% of patients included blurred vision, eye pain, eye irritation, eye pruritus, and headache.
  
  
  CONCLUSIONS
  Besifloxacin 0.6% ophthalmic suspension 3 times a day for 5 days is safe and effective for BC. Twice-a-day dosing for 3 days was also effective-a simplified regimen compared with other fluoroquinolones. Disadvantages include price and lack of a generic. Further evaluation is needed to evaluate comparative efficacy among other ocular fluoroquinolones and unlabeled uses.
authors.affiliation: University of Wyoming School of Pharmacy, Laramie, WY, USA.
authors.forename: Tracy D
authors.initials: TD
authors.lastname: Mahvan
authors.forename: Jaime R
authors.initials: JR
authors.lastname: Hornecker
authors.forename: Whitney A
authors.initials: WA
authors.lastname: Buckley
authors.forename: Suzanne
authors.initials: S
authors.lastname: Clark
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001381:Azepines / Q000009:adverse effects / Q000627:therapeutic use*; D003234:Conjunctivitis, Bacterial / Q000188:drug therapy*; D024841:Fluoroquinolones / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D001381:Azepines; D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; C522124:besifloxacin
keywords: bacterial conjunctivitis; bacterial eradication; besifloxacin; ophthalmic fluoroquinolones