Topical Vancomycin 5% Is More Efficacious Than 2.5% and 1.25% for Reducing Viable Methicillin-Resistant Staphylococcus aureus in Infectious Keratitis
| Autor: | Regis P. Kowalski, Deepinder K. Dhaliwal, Robert M. Q. Shanks, Eric G. Romanowski, John E Romanowski, Vishal Jhanji, Kathleen A. Yates, Alex Mammen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
medicine.medical_treatment Colony Count Microbial Administration Ophthalmic Microbial Sensitivity Tests Infectious Keratitis medicine.disease_cause Eye Infections Bacterial Corneal ulceration Keratitis 03 medical and health sciences 0302 clinical medicine Vancomycin Animals Medicine Corneal Ulcer Saline business.industry Staphylococcal Infections biochemical phenomena metabolism and nutrition Eye infection medicine.disease Methicillin-resistant Staphylococcus aureus eye diseases Anti-Bacterial Agents Ophthalmology Treatment Outcome Staphylococcus aureus Anesthesia 030221 ophthalmology & optometry Female Rabbits sense organs business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Cornea. 39:250-253 |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000002186 |
| Popis: | Purpose Topical vancomycin 5% (50 mg/mL) has been used for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) keratitis, but patient comfort has many clinicians using lower concentrations. We compared the efficacy of different concentrations of vancomycin in the treatment of experimental MRSA keratitis. Methods The corneas of 45 rabbits were infected with 2000 colony-forming units (CFUs) of MRSA. Corneal epithelium was abraded in the left eyes to mimic corneal ulceration. After 4 hours, the corneal CFUs were determined at the onset of treatment. The remaining rabbits were divided into 4 treatment groups (n = 9): 1) vancomycin 5%, 2) vancomycin 2.5%, 3) vancomycin 1.25%, and 4) saline. The rabbits were treated topically in both eyes every 15 minutes for 5 hours. One hour after treatment, the rabbits were clinically examined and euthanized, corneas were removed, and CFUs were determined to analyze vancomycin penetration, treatment efficacy, and bactericidal effect. Results Ocular toxicity was concentration dependent from mild to moderate. For the abraded corneas, the CFUs of the vancomycin 5% group were lower than 2.5% and 1.25%, and all vancomycin groups were lower than saline. The CFUs of 2.5% were lower but similar to 1.25%. The vancomycin 5% group demonstrated a bactericidal effect and the best penetration. The CFUs of the abraded corneas treated with saline were lower than those of the intact corneas, indicating a possible antibacterial effect from the ocular surface. Conclusions Vancomycin 5% was most potent for treating experimental MRSA keratitis. The clinician may need to reassess treatment regarding antibacterial efficacy and patient comfort. |
| Databáze: | OpenAIRE |
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