A European Perspective on Topical Ophthalmic Antibiotics: Current and Evolving Options

Abstract

BackgroundEye infections can be vision-threatening and must be treated effectively by appropriate and safe use of topical ophthalmic anti-infectives. This review will essentially consider the current and evolving treatment options for the various types of bacterial eye infections. Ocular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children.MethodsThis article presents a review of the peer-reviewed published scientific literature in order to define the well-established uses of anti-infective eye drops in the field of ocular infections. A comprehensive search of the recent published literature including topical ophthalmic anti-infectives effective in bacterial ocular infections was performed. Clinical studies provide relevant data concerning the characteristics and clinical efficacy of antibacterial eye drops in ocular anterior segment infections or for perioperative prophylaxis. Publications were included to cover the current options of antibacterial eye drops available in Europe.ResultsSeveral recent publications identified effective topical ocular antibacterials requiring a reduced dose regimen and a short treatment course. Additional literature reviewed included data on novel perioperative prophylaxis, indications for topical fortified antibiotics and innovative research including the risk of resistance.ConclusionsSafe and effective topical antibiotic eye drops for the treatment and prevention of ocular infections must be adapted to the type of bacteria suspected. Usual topical antimicrobials should be replaced by more recent and more effective treatments. The use of highly effective fluoroquinolones should be reserved for the most severe cases to avoid resistance. Short treatment courses, such as azithromycin, can be easily used in children, thereby improving quality of life.

Efficacy and safety of azithromycin 1.5% eye drops in paediatric population with purulent bacterial conjunctivitis

“…Most currently licensed topical antibiotics for bacterial conjunctivitis have been approved based on clinical studies conducted mainly in adults11, with insufficient clinical data in newborns and infants (ie, <24 months). This study has now established the efficacy and safety of azithromycin 1.5% eye drops in children with an average age of 3 years old.…”

2018 Update on Intravitreal Injections: Euretina Expert Consensus Recommendations

“…Growing resistance among ocular bacteria has been observed following overuse of systemic as well as topical antibiotics in the eye. For further information, see Grzybowski et al [111] and Bremond-Gignac et al [112]. …”

Pediatric ocular nanomedicines: Challenges and opportunities

“…Though mild cases have the potential of resolving on their own, the availability of antibiotics specific to children suffering from more severe cases of bacterial conjunctivitis is limited. Despite ongoing global efforts to invigorate clinical trials in the pediatric population, the safety and efficacy of most topical antibiotics have been proven and subsequently approved based on studies in adults [13]. Topical administration of the treatment was favorable in the way of safety, comfort, and tolerance [10].…”