Effectiveness of Ciprofloxacin, Levofloxacin, or Moxifloxacin for Treatment of Experimental Staphylococcus aureus Keratitis

Abstract

The purpose of this study was to quantitatively compare, in a rabbit keratitis model, the levels of effectiveness of moxifloxacin, levofloxacin, and ciprofloxacin for the treatment of Staphylococcus aureus isolates of diverse antibiotic susceptibilities. Rabbit eyes were intrastromally injected with approximately 100 CFU of methicillinsensitive or methicillin-resistant S. aureus (MSSA or MRSA, respectively) organisms that were either sensitive or resistant to ofloxacin. One drop of moxifloxacin (0.5%), levofloxacin (0.5%), or ciprofloxacin (0.3%) was topically applied hourly from 4 to 9 (early) or 10 to 15 (late) h postinfection. At 1 h after cessation of therapy, the corneas were harvested, and the number of CFU per cornea was determined. For the ofloxacin-sensitive strains, early treatment of MSSA or MRSA with moxifloxacin, levofloxacin, or ciprofloxacin produced approximately a 5-log decrease in CFU per cornea relative to that in untreated eyes (P < 0.0001). For late therapy of ofloxacin-sensitive strains, moxifloxacin, levofloxacin, and ciprofloxacin produced approximately 5-, 4-, and 2-to 3-log reductions in CFU per cornea, respectively (P < 0.0001). Early treatment of the ofloxacin-resistant strains with either moxifloxacin or levofloxacin produced a >4-log or >3-log decrease, respectively, in the MSSA or MRSA strains (P < 0.0001), whereas ciprofloxacin treatment produced a 1-log decrease in CFU per cornea relative to that in untreated eyes (P ‫؍‬ 0.1540). For late treatment of ofloxacin-resistant strains, levofloxacin and ciprofloxacin failed to significantly reduce the number of CFU per cornea (P > 0.3627), whereas moxifloxacin produced a significant reduction in CFU per cornea of approximately 1 log (P < 0.0194). Therefore, for three of the four treatments tested, moxifloxacin demonstrated greater effectiveness than either levofloxacin or ciprofloxacin.

Polyelectrolyte complex materials from chitosan and gellan gum

“…Levofloxacin has been used actively in ophthalmic solutions [285][286][287] for the treatment of ocular bacterial infections 288 . Bezwada et al 289 reported the intrinsic cytotoxicity of ophthalmic solutions containing levofloxacin in on human corneal keratocytes (HCK) and human corneal endothelial cells (HCE).…”

Controlled drug release from hydrogels for contact lenses: Drug partitioning and diffusion

“…Chlorhexidine is used as antibacterial agent and topical disinfectant (Mathers, 2006), levofloxacin is an antibiotic that is widely used both in the prophylaxis and treatment of ocular infections (Dajcs et al, 2004), and diclofenac is a nonsteroidal, antiinflammatory drug with analgesic activity (Goa and Chrisp, 1992). The characteristics of the drugs are given in Table 1.…”

Effect of formulation factors on in vitro permeation of moxifloxacin from aqueous drops through excised goat, sheep, and buffalo corneas

“…5 In experimental staphylococcal keratitis model in rabbits, moxifloxacin has demonstrated greater effectiveness than ciprofloxacin or levofloxacin. 6 Experiments in rabbits suggest that surgical prophylaxis with topical 0.5% moxifloxacin could be effective for prevention of bacterial endophthalmitis. 7,8 Moxifloxacin is available as hydrochloride salt, which is water soluble.…”