Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery

Frank A Bucci Jr,1 Ruth E Evans,1 Loretta M Amico,1 Timothy W Morris,2 Angel T Fluet,1 Christine M Sanfilippo,3 Heleen H DeCory,3 Timothy L Comstock3 1Bucci Laser Vision Institute, Wilkes-Barre, PA, USA; 2Microbiology and Sterilization Sciences, Bausch and Lomb, Rochester, NY, USA; 3Medical Affairs...

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Main Authors: Bucci FA Jr, Evans RE, Amico LM, Morris TW, Fluet AT, Sanfilippo CM, DeCory HH, Comstock TL
Format: Article
Language:English
Published: Dove Medical Press 2015-05-01
Series:Clinical Ophthalmology
Online Access:http://www.dovepress.com/antibacterial-efficacy-of-prophylactic-besifloxacin-06-and-moxifloxaci-peer-reviewed-article-OPTH
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author Bucci FA Jr
Evans RE
Amico LM
Morris TW
Fluet AT
Sanfilippo CM
DeCory HH
Comstock TL
author_facet Bucci FA Jr
Evans RE
Amico LM
Morris TW
Fluet AT
Sanfilippo CM
DeCory HH
Comstock TL
author_sort Bucci FA Jr
collection DOAJ
description Frank A Bucci Jr,1 Ruth E Evans,1 Loretta M Amico,1 Timothy W Morris,2 Angel T Fluet,1 Christine M Sanfilippo,3 Heleen H DeCory,3 Timothy L Comstock3 1Bucci Laser Vision Institute, Wilkes-Barre, PA, USA; 2Microbiology and Sterilization Sciences, Bausch and Lomb, Rochester, NY, USA; 3Medical Affairs, Bausch and Lomb, Rochester, NY, USA Background: The purpose of this study was to investigate the ocular bacterial flora in patients scheduled to undergo cataract surgery and compare the antibacterial effects of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in these patients. Methods: This was a prospective, randomized, laboratory-masked clinical trial. Patients received besifloxacin or moxifloxacin “quater in die” or QID (four times a day) for 3 days before cataract surgery in the surgical eye and 1 hour before surgery in the nonsurgical fellow eye. Conjunctival and eyelid swabs were obtained from both eyes at baseline and after treatment, on the day of surgery (Visit 2). Swabs were processed for bacterial colony counts (in terms of colony-forming units) and species identification. In vitro antibiotic susceptibilities of isolates were determined using Clinical and Laboratory Standards Institute breakpoints. Results: Fifty-nine patients (n=28 besifloxacin, n=31 moxifloxacin) completed the study. The majority (73%) of conjunctival samples were culture negative at baseline. The most frequent isolates were coagulase-negative staphylococci (CoNS, 89%), specifically Staphylococcus epidermidis (72%). Both fluoroquinolones reduced the lid CFU values when administered QID for 3 days (P≤0.019), but only besifloxacin reduced the lid CFU estimate 1 hour following instillation of a single drop (P=0.039). Fewer besifloxacin-treated eyes had lids that were culture positive for CoNS at Visit 2 compared with moxifloxacin-treated eyes regardless of dosing regimen (P≤0.03). The minimum inhibitory concentration (MIC90) of besifloxacin against methicillin-resistant S. epidermidis (MRSE) was eightfold lower than that of moxifloxacin. Conclusion: Besifloxacin appeared more effective in reducing bacterial counts on eyelids of patients undergoing cataract surgery, with significant reductions as early as 1 hour postdose, compared with moxifloxacin. Besifloxacin was more active in vitro against MRSE. Keywords: besifloxacin, moxifloxacin, prophylaxis, cataract patients, coagulase-negative staphylococci
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spelling doaj.art-7149eed1fd3740cc9fd449aa062b90ff2022-12-21T17:17:39ZengDove Medical PressClinical Ophthalmology1177-54832015-05-012015default84385221700Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgeryBucci FA JrEvans REAmico LMMorris TWFluet ATSanfilippo CMDeCory HHComstock TLFrank A Bucci Jr,1 Ruth E Evans,1 Loretta M Amico,1 Timothy W Morris,2 Angel T Fluet,1 Christine M Sanfilippo,3 Heleen H DeCory,3 Timothy L Comstock3 1Bucci Laser Vision Institute, Wilkes-Barre, PA, USA; 2Microbiology and Sterilization Sciences, Bausch and Lomb, Rochester, NY, USA; 3Medical Affairs, Bausch and Lomb, Rochester, NY, USA Background: The purpose of this study was to investigate the ocular bacterial flora in patients scheduled to undergo cataract surgery and compare the antibacterial effects of besifloxacin ophthalmic suspension 0.6% and moxifloxacin ophthalmic solution 0.5% in these patients. Methods: This was a prospective, randomized, laboratory-masked clinical trial. Patients received besifloxacin or moxifloxacin “quater in die” or QID (four times a day) for 3 days before cataract surgery in the surgical eye and 1 hour before surgery in the nonsurgical fellow eye. Conjunctival and eyelid swabs were obtained from both eyes at baseline and after treatment, on the day of surgery (Visit 2). Swabs were processed for bacterial colony counts (in terms of colony-forming units) and species identification. In vitro antibiotic susceptibilities of isolates were determined using Clinical and Laboratory Standards Institute breakpoints. Results: Fifty-nine patients (n=28 besifloxacin, n=31 moxifloxacin) completed the study. The majority (73%) of conjunctival samples were culture negative at baseline. The most frequent isolates were coagulase-negative staphylococci (CoNS, 89%), specifically Staphylococcus epidermidis (72%). Both fluoroquinolones reduced the lid CFU values when administered QID for 3 days (P≤0.019), but only besifloxacin reduced the lid CFU estimate 1 hour following instillation of a single drop (P=0.039). Fewer besifloxacin-treated eyes had lids that were culture positive for CoNS at Visit 2 compared with moxifloxacin-treated eyes regardless of dosing regimen (P≤0.03). The minimum inhibitory concentration (MIC90) of besifloxacin against methicillin-resistant S. epidermidis (MRSE) was eightfold lower than that of moxifloxacin. Conclusion: Besifloxacin appeared more effective in reducing bacterial counts on eyelids of patients undergoing cataract surgery, with significant reductions as early as 1 hour postdose, compared with moxifloxacin. Besifloxacin was more active in vitro against MRSE. Keywords: besifloxacin, moxifloxacin, prophylaxis, cataract patients, coagulase-negative staphylococcihttp://www.dovepress.com/antibacterial-efficacy-of-prophylactic-besifloxacin-06-and-moxifloxaci-peer-reviewed-article-OPTH
spellingShingle Bucci FA Jr
Evans RE
Amico LM
Morris TW
Fluet AT
Sanfilippo CM
DeCory HH
Comstock TL
Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
Clinical Ophthalmology
title Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
title_full Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
title_fullStr Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
title_full_unstemmed Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
title_short Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery
title_sort antibacterial efficacy of prophylactic besifloxacin 0 6 and moxifloxacin 0 5 in patients undergoing cataract surgery
url http://www.dovepress.com/antibacterial-efficacy-of-prophylactic-besifloxacin-06-and-moxifloxaci-peer-reviewed-article-OPTH
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