Tungsiripat Tulaya, Sarayba Melvin A, Kaufman Matthew B, Sweet Paula M, Taban Mehran, Carpenter Thomas R, McDonnell Peter J
Department of Ophthalmology, University of California Irvine, Irvine, California 92697, USA.
Am J Ophthalmol. 2003 Jul;136(1):76-81. doi: 10.1016/s0002-9394(02)02280-8.
To assess the effectiveness of a fourth-generation fluoroquinolone for prophylaxis against multiple drug-resistant staphylococcal keratitis after lamellar keratectomy in a rabbit model.
Experimental study.
Twenty-eight New Zealand white rabbits underwent unilateral lamellar keratectomy using a manual microkeratome followed by the placement of 1000 colony-forming units (CFUs) of log-phase Staphylococcus aureus bacteria under each flap. Eyes (seven in each group) were randomized and treated with one of the following agents: sterile balanced salt solution, gatifloxacin (0.3%), ciprofloxacin (0.3%) or levofloxacin (0.5%) immediately and 6, 12, and 18 hours after surgery. Inflammation was graded by two masked observers at 24 and 48 hours, and the presence or absence of infectious infiltrates was determined. The means and standard deviations were calculated, and differences among the groups were statistically analyzed.
There were no flap complications encountered during surgery. Eyes treated with ciprofloxacin, levofloxacin, and balanced salt solution developed infectious infiltrates in five of seven eyes per group. Gatifloxacin-treated eyes did not develop clinical infection and exhibited lower mean inflammation scores (P <.01 compared with the other groups).
The fourth-generation fluoroquinolone, gatifloxacin, is an effective prophylaxis against the development of keratitis after lamellar keratectomy in rabbits with an organism resistant to methicillin, levofloxacin, and ciprofloxacin.
在兔模型中评估一种第四代氟喹诺酮类药物预防板层角膜切除术后多重耐药性葡萄球菌性角膜炎的有效性。
实验研究。
28只新西兰白兔使用手动微型角膜刀进行单侧板层角膜切除术，然后在每个角膜瓣下放置1000个对数期金黄色葡萄球菌菌落形成单位（CFU）。将眼睛（每组7只）随机分组，术后即刻以及术后6、12和18小时分别用以下药物之一进行治疗：无菌平衡盐溶液、加替沙星（0.3%）、环丙沙星（0.3%）或左氧氟沙星（0.5%）。由两名不知情的观察者在术后24小时和48小时对炎症进行分级，并确定是否存在感染性浸润。计算均值和标准差，并对组间差异进行统计学分析。
手术过程中未出现角膜瓣并发症。环丙沙星、左氧氟沙星和平衡盐溶液治疗组的眼睛每组有5只出现感染性浸润。加替沙星治疗的眼睛未发生临床感染，且平均炎症评分较低（与其他组相比，P<.01）。
第四代氟喹诺酮类药物加替沙星可有效预防对甲氧西林、左氧氟沙星和环丙沙星耐药的生物体感染的兔在板层角膜切除术后发生角膜炎。
