Article

Topical antibiotic treatment effective in preventing endophthalmitis

Salt Lake City-Topical antibiotic therapy before and after intraocular bacterial challenge in rabbits could prevent Staphylococcus epidermidis endophthalmitis from developing.

Prophylaxis with a 3-mg/ml gatifloxacin (Zymar, Allergan) presoaked collagen shield was associated with lower rates of endophthalmitis if compared with prophylaxis with 5-mg/ml moxifloxacin (Vigamox, Alcon Laboratories) presoaked shields, Brian Haugen, MD, reported.

"Endophthalmitis is a devastating complication following surgery. The Moran Eye Center just published a reported indicating that 27 of 1,525 patients developed endophthalmitis over a 7-year period," Dr. Haugen said.

First the investigators needed to determine the minimal concentration of Sepidermidis that could induce clinical signs of endophthalmitis.

Group 1 of rabbits received 3 mg/ml gatifloxacin drops or the collagen shield soaked in 3 mg/ml gatifloxacin. Group 2 received gatifloxacin drops or a collagen shield soaked in 10 mg/ml of gatifloxacin (Tequin, Bristol-Myers Squibb). Group 3 animals were given 5 mg/ml moxifloxacin drops, or a shield soaked in 5-mg/ml moxifloxacin. Finally, Group 4, the control group, received balanced saline solution (BSS) drops or a shield soaked in BSS. Each eye received one drop of gatifloxacin, moxifloxacin, or BSS four times beginning 1 hour before the bacterial injection. Immediately after the injection, the collagen shield was placed in the eye randomly assigned to receive the shield.

The antibiotic drops were instilled once every 2 hours postoperatively for a total of five doses, according to Dr. Haugen. The animals in the gatifloxacin group received the 3-mg/ml gatifloxacin drops to determine if the collagen shield soaked in a higher concentration of gatifloxacin made a difference in the treatment results.

Signs of endophthalmitis

Twenty-four hours after the bacterial challenge, the animals were examined by slit lamp to determine the presence of the clinical signs of endophthalmitis. The different clinical parameters were scored by a scale ranging from 0 to 4, with 4 representing the presence of the worst clinical signs of endophthalmitis. Then, a total clinical score was noted for each eye.

"The reaction with the antibiotic-soaked shields in place was not as intense as in the control group. There was more cell and flare in the eyes with a moxifloxacin shield," Dr. Haugen stated.

He also reported that the main clinical scores for the shields were not significantly different from those of the topical drops alone.

Related Videos
Image credit: Ophthalmology Times; EnVision Summit 2025: Sonia H. Yoo, MD, shares what to expect from the cataract and refractive agenda
Ophthalmology Times: Kathryn Colby, MD, PhD, reflects on National Women Physicians Day
2 experts are featured in this series.
2 experts are featured in this series.
2 experts are featured in this series.
2 experts are featured in this series.
© 2025 MJH Life Sciences

All rights reserved.