Comparative <i>In Vitro</i> Susceptibility of Besifloxacin and Seven Comparators Against Ciprofloxacin- and Methicillin-Susceptible/Nonsusceptible Staphylococci

Miller, Darlene; Chang, Jonathan S.; Flynn, Harry W.; Alfonso, Eduardo C.

doi:10.1089/jop.2012.0081

Cited by 39 publications

(24 citation statements)

References 23 publications

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“…42 Similar to results obtained with the Gram-negative pathogens of concern, bacterial eradication rates in patients with MRSA and MRSE infections treated with besifloxacin ophthalmic suspension were high -81.2% by the first follow-up visit, increasing to 87.8% by the second follow-up visit -and significantly higher than those obtained in patients with these infections treated with vehicle (P#0.014). Eradication rates were also high in the subset of infections with CipR-MRSA or CipR-MRSE -88.5% at first follow-up visit, increasing to 92.3% by the second follow-up visit -suggesting that the combination of low MIC 90 and sustained ocular surface drug concentrations provides excellent coverage for these multidrug-resistant infections.…”

supporting

confidence: 69%

“…40 This balanced activity, in turn, results in broad-spectrum in vitro activity, including activity against P. aeruginosa, S. marcescens, and Neisseria spp., as well as ciprofloxacin-resistant (CipR) and methicillin-resistant staphylococcal isolates. 6,31,32,41,42 The ophthalmic formulation of besifloxacin, which contains 0.663% besifloxacin hydrochloride or 0.6% besifloxacin free base (Besivance ® ; Bausch + Lomb, Bridgewater, NJ, USA) 39 is formulated with DuraSite ® (InSite Vision, Alameda, CA, USA), a mucoadhesive polycarbophil polymer designed to prolong a drug's residence time on the ocular surface and improve bioavailability. [43][44][45][46] DuraSite has also been reported to inhibit staphylococcal biofilm formation in vitro.…”

mentioning

confidence: 99%

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Clinical outcomes with besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis due to potentially consequential pathogens

Comstock¹,

Morris²,

Gearinger³

et al. 2014

OPTO

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Purpose: Besifloxacin is a chlorofluoroquinolone approved for use in the treatment of bacterial conjunctivitis. This study assessed the clinical efficacy of besifloxacin ophthalmic suspension 0.6% against conjunctivitis infections caused by potentially consequential pathogens. Design: Post hoc analysis of clinical outcomes for patients with conjunctival infections due to Pseudomonas aeruginosa, Serratia marcescens, Neisseria spp., methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant Staphylococcus epidermidis (MRSE) who were treated with besifloxacin in four multicenter, double-masked, randomized clinical trials. Methods: Minimum inhibitory concentrations (MICs) of besifloxacin against potentially consequential pathogens were pooled. Clinical outcome data for patients treated with besifloxacin with baseline infections due to these pathogens were pooled and summarized. Bacterial eradication was defined as the absence of ocular bacterial species present at or above threshold at baseline. Results: A total of 1,317 patients had culture-confirmed bacterial conjunctivitis across the four studies, and 151 infections were due to the aforementioned pathogens (P. aeruginosa n=9; S. marcescens n=10; Neisseria spp. n=16; MRSA n=35; MRSE n=81). Among MRSA and MRSE infections, 48.3% demonstrated concurrent ciprofloxacin resistance (ciprofloxacinresistant [CipR]-MRSA n=24; CipR-MRSE n=32). The MIC 90 (MIC for 90% of isolates) for besifloxacin was 1 µg/mL for S. marcescens, 0.25 µg/mL for Neisseria spp., 0.06 µg/mL for both ciprofloxacin-sensitive MRSA and ciprofloxacin-sensitive MRSE, and 4 µg/mL for both CipR-MRSA and CipR-MRSE. Against P. aeruginosa, the MIC range was 1-4 µg/mL. Bacterial eradication rates in patients treated with besifloxacin were 100% by the first follow-up visit for infections due to P. aeruginosa, S. marcescens, and Neisseria spp. and 87.8% by the second follow-up visit for infections due to MRSA and MRSE. Conclusion: The use of besifloxacin ophthalmic suspension 0.6% in the treatment of conjunctival infections due to potentially consequential pathogens resulted in high rates of bacterial eradication.

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supporting

confidence: 69%

mentioning

confidence: 99%

Clinical outcomes with besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis due to potentially consequential pathogens

Comstock¹,

Morris²,

Gearinger³

et al. 2014

OPTO

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“…We found strikingly elevated rates of nonsusceptibility among our MRSE isolates to the fluoroquinolones ciprofloxacin, ofloxacin and moxifloxacin and other topically used antibiotics such as azithromycin and gentamicin. Previous reports have also demonstrated markedly higher rates of resistance among MRSA and methicillinresistant CoNS (including MRSE) isolates from ocular infections (12,(46)(47)(48). In addition, extensive use of fluoroquinolones is a known risk factor associated with increased incidence of MRSA carriage and infections (49,50).…”

Section: Discussionmentioning

confidence: 97%

Characterization of Ocular Methicillin-Resistant Staphylococcus epidermidis Isolates Belonging Predominantly to Clonal Complex 2 Subcluster II

2014

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Staphylococcus epidermidis is an abundant member of the microbiota of the human skin and wet mucosa, which is commonly associated with sight-threatening infections in eyes with predisposing factors. Ocular S. epidermidis has become notorious because of its capability to form biofilms on different ocular devices and due to the evolving rates of antimicrobial resistance. In this study, the molecular epidemiology of 30 ocular methicillin-resistant S. epidermidis (MRSE) isolates was assessed using multilocus sequence typing (MLST). Antimicrobial resistance, accessory gene-regulator and staphylococcal cassette chromosome mec (SCCmec) types, biofilm formation, and the occurrence of biofilm-associated genes were correlated with MLST clonal complexes. Sequence types (STs) frequently found in the hospital setting were rarely found in our collection. Overall, 12 different STs were detected with a predominance of ST59 (30%), ST5 and ST6 (13.3% each). Most of the isolates (93.3%) belonged to the clonal complex 2 (CC2) and grouped mainly within subcluster CC2-II (92.9%). Isolates grouped within this subcluster were frequently biofilm producers (92.3%) with a higher occurrence of the aap (84.5%) and bhp (46.1%) genes compared to icaA (19.2%). SCCmec type IV (53.8%) was predominant within CC2-II strains, while 38.4% were nontypeable. In addition, CC2-II strains were frequently multidrug resistant (80.7%) and demonstrated to be particularly resistant to ciprofloxacin (80.8%), ofloxacin (77%), azithromycin (61.5%), and gentamicin (57.7%). Our findings demonstrate the predominance of a particular MRSE cluster causing ocular infections, which was associated with high rates of antimicrobial resistance and particularly the carriage of biofilm-related genes coding for proteinaceous factors implicated in biofilm accumulation.

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“…Besifloxacin is a new fluoroquinolone that has shown greater potency than moxifloxacin and ciprofloxacin against Staphylococci isolated from various ocular sites and will likely become an important player in the battle against organisms resistant to existing fluoroquinolones. 23,25 Additionally, besifloxacin is effective against MRSA, unlike most of the other fluoroquinolones, which lack MRSA activity. 23,26 Efficacy against MRSA is a critical consideration because the incidence of serious ocular infections caused by MRSA has been increasing.…”

Section: Discussionmentioning

confidence: 99%

Community Practice Patterns for Bacterial Corneal Ulcer Evaluation and Treatment

Park

Lee

Zhou

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Comparative In Vitro Susceptibility of Besifloxacin and Seven Comparators Against Ciprofloxacin- and Methicillin-Susceptible/Nonsusceptible Staphylococci

Cited by 39 publications

References 23 publications

Clinical outcomes with besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis due to potentially consequential pathogens

Clinical outcomes with besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis due to potentially consequential pathogens

Characterization of Ocular Methicillin-Resistant Staphylococcus epidermidis Isolates Belonging Predominantly to Clonal Complex 2 Subcluster II

Community Practice Patterns for Bacterial Corneal Ulcer Evaluation and Treatment

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