title: Efficacy of Topical Levofloxacin 0.5% in Treating Levofloxacin-Resistant Pseudomonas aeruginosa-Induced Keratitis.
abstract: OBJECTIVE
  To evaluate the efficacy of topical levofloxacin 0.5% in treating levofloxacin-resistant Pseudomonas aeruginosa-induced keratitis.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  The study was conducted in 21 New Zealand White rabbits whose corneas were inoculated with 0.1 mL of 1000 colony-forming units of levofloxacin-resistant P. aeruginosa. After 24 hours, the rabbits were randomized into 3 groups: 9 were treated with levofloxacin 0.5%, 6 were treated with ceftazidime 50 mg/mL, and 6 were treated with a placebo. The rabbits were given a loading dose once every 5 minutes in the first hour and continued to receive a dose once an hour in the next 11 hours. Afterward, 3 rabbits treated with levofloxacin were killed. Their corneas were examined for levofloxacin concentration. The remaining rabbits continued to receive 6 regular doses for 4 more days, each of which was administered at a 2-hour interval. Levofloxacin concentration was examined. Treatment efficacy was evaluated based on 4 clinical characteristics: corneal infiltrate, conjunctival edema, conjunctival injection, and discharge.
  
  
  RESULTS
  All clinical characteristics, except conjunctival edema, improved significantly in rabbits treated with either levofloxacin or ceftazidime, compared to the placebo group. At the last follow-up (120 hours), all clinical characteristics improved significantly in both treatment groups. Mean corneal levofloxacin concentration in the treatment groups was 6.25 (0.32) μg/g, which declined significantly to a mean of 2.15 (1.23) μg/g after another 120 hours.
  
  
  CONCLUSIONS
  Topical levofloxacin 0.5% improved the clinical characteristics of keratitis induced by levofloxacin-resistant P. aeruginosa. Such improvement could be attributed to a high concentration of levofloxacin that was above the minimum inhibitory level.
authors.affiliation: From the Departments of *Ophthalmology, †Microbiology, and‡Pharmacology, Cipto Mangunkusumo Hospital - University of Indonesia, Central Jakarta City, Indonesia.
authors.forename: Kianti R
authors.initials: KR
authors.lastname: Darusman
authors.forename: Ratna
authors.initials: R
authors.lastname: Sitompul
authors.forename: Made
authors.initials: M
authors.lastname: Susiyanti
authors.forename: Pratiwi
authors.initials: P
authors.lastname: Sudarmono
authors.forename: Ari
authors.initials: A
authors.lastname: Estuningtyas