A phase III clinical trial of 0.5% levofloxacin ophthalmic solution versus 0.3% ofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis

Schwab, Ivan R.; Friedlaender, Mitchell H.; McCulley, James P.; Lichtenstein, Steven J.; Moran, Ciaran

doi:10.1016/s0161-6420(02)01894-8

Cited by 61 publications

(20 citation statements)

References 17 publications

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“…80%) at days 6 to 10. 51 As expected, the clinical cure rate with gatifloxacin 0.3% ophthalmic solution, one of the newer fluoroquinolones, was significantly higher than with ofloxacin 0.3% ophthalmic solution (72.3 vs. 63.5%) in a comparative trial for bacterial conjunctivitis. 52 There was no difference in either clinical resolution or bacterial eradication between moxifloxacin ophthalmic solution 0.5% and besifloxacin ophthalmic suspension 0.6% in a recent non-inferiority study.…”

Section: Fluoroquinolonessupporting

confidence: 61%

“…53 The ophthalmic preparations of the fluoroquinolones ciprofloxacin, ofloxacin, levofloxacin, and gatifloxacin require more frequent administration (e.g., every 2 h for 2 days, then four times a day for the next 5 days) than moxifloxacin, which is administered 3 times a day for 7 days, and besifloxacin, which is administered 3 times a day at 4 to 12 h intervals for 7 days (Table 2). 6,11,12,54,55 Fluoroquinolone ophthalmic preparations are well tolerated 43,45,47,50,51,56 and are associated with less toxicity than older antibiotics. 10,11,12,23 Ocular adverse events with topical fluoroquinolones generally are mild and self-limiting and have included conjunctivitis, pruritus, discomfort, transient burning, stinging, and photophobia.…”

Section: Fluoroquinolonesmentioning

confidence: 99%

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Limitations of Current Antibiotics for the Treatment of Bacterial Conjunctivitis

Karpecki

Paterno

Comstock

2010

Optometry and Vision Science

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Bacterial conjunctivitis is a common ocular infection that is generally treated empirically with a broad-spectrum antibiotic. The more common pathogens causing bacterial conjunctivitis include Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus epidermidis, and Moraxella species. Several antibiotics traditionally used to treat bacterial conjunctivitis are no longer widely prescribed because of increased bacterial resistance and/or safety concerns. The introduction of the fluoroquinolone class of anti-infectives offered effective and better tolerated treatment options. Nonetheless, successful therapy for bacterial conjunctivitis continues to be limited by several factors. A primary concern is the development of bacterial resistance that may be impacted not only by widespread antibiotic use but also by antibacterial pharmacokinetics, such as maintenance of insufficient bactericidal concentrations at the site of infection. In addition, poor adherence to prescribed regimens that require frequent administration, along with undesirable adverse events, affects the development of bacterial resistance and the success of treatment regimens. This article reviews current antibacterial agents used to treat bacterial conjunctivitis, factors that limit their successful use in treatment, and options for future development of more effective topical ophthalmic anti-infective agents.

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Section: Fluoroquinolonessupporting

confidence: 61%

Section: Fluoroquinolonesmentioning

confidence: 99%

Limitations of Current Antibiotics for the Treatment of Bacterial Conjunctivitis

Karpecki

Paterno

Comstock

2010

Optometry and Vision Science

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“…In these age groups, pathogens are frequently associated with epidemic occurrences of bacterial conjunctivitis. In infants, children and teenagers, the most common ocular pathogens are Staphylococcus aureus , Haemophilus influenzae , Streptococcus pneumoniae , and also Moraxella species 5–7…”

Section: Current Use Of Topical Antibacterial Eye Dropsmentioning

confidence: 99%

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

2011

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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.

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“…Levofloxacin has activity against both Gram-positive and Gram-negative bacteria. 9 Various studies have been carried out to determine the safety and efficacy of levofloxacin as a treatment for conjunctivitis and keratitis 10,11 and of intravitreal levofloxacin in Staphylococcus epidermidis endophthalmitis. 8,12 As the route for administration, systemic antibiotics have been used concurrently for bacterial endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the levofloxacin release characters from a rabbit foldable capsular vitreous body

Jiang

Wang²,

Pan³

et al. 2011

IJN

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The authors have manufactured a novel rabbit foldable capsular vitreous body (FCVB). The aim of this study was to determine whether this rabbit FCVB can release levofloxacin in vitro and in vivo, and to evaluate the release characteristics. In vitro, the rabbit FCVB with levofloxacin 500 μg/mL was immersed in cups of modified Franz diffusion cells. Following this, 200 μL of liquid was aspirated at intervals from 10 minutes to 24 hours. In vivo, the FCVB with levofloxacin was implanted into the right eyes of five rabbits. After implantation, the aqueous humor was aspirated on days 1, 7, 14, 28, and 56. The levofloxacin concentrations in the cups and aqueous humor samples were detected by high-performance liquid chromatography–tandem mass spectrometry. The FCVB was observed under a scanning electron microscope. The results showed that the released levofloxacin was stabilized at 20 ng/mL at time points from 10 minutes to 24 hours in vitro. In vivo, levofloxacin concentrations in the aqueous humor were 132, 50, 39, 11, and 15 ng/mL on days 1, 7, 14, 28, and 56, respectively. In the FCVB capsules, 300 nm apertures were observed. These results suggest the rabbit FCVB released levofloxacin stably in vitro and sustainably in vivo. This study provides a novel combined approach, with the FCVB as a vitreous substitute and drug delivery system for the treatment of bacterial endophthalmitis.

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A phase III clinical trial of 0.5% levofloxacin ophthalmic solution versus 0.3% ofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis

Cited by 61 publications

References 17 publications

Limitations of Current Antibiotics for the Treatment of Bacterial Conjunctivitis

Limitations of Current Antibiotics for the Treatment of Bacterial Conjunctivitis

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

Evaluation of the levofloxacin release characters from a rabbit foldable capsular vitreous body

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