Wilhelmus Kirk R, Abshire Robert L, Schlech Barry A
Sid W. Richardson Ocular Microbiology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
Arch Ophthalmol. 2003 Sep;121(9):1229-33. doi: 10.1001/archopht.121.9.1229.
To estimate how a corneal isolate's minimal inhibitory concentration for a fluoroquinolone agent affects the rate of clinical response of bacterial keratitis to fluoroquinolone therapy.
Prospective cohort study.
Six hundred sixty-three individuals with suspected bacterial keratitis underwent diagnostic corneal scraping and were treated with topical 0.3% ciprofloxacin solution or ointment. Of 407 patients with culture-confirmed bacterial keratitis, improvement and cure rates with ciprofloxacin monotherapy were estimated for 391 who had in vitro ciprofloxacin susceptibility of the principal corneal isolate.
Slitlamp biomicroscopic assessment for clinical improvement of corneal inflammation and for clinical cure with complete reepithelialization.
Adjusted rates of improvement and of cure were reduced, respectively, by 43% (95% confidence limits, 8%, 64%) and by 29% (95% confidence limits, 0%, 49%) among corneal infections having a ciprofloxacin minimal inhibitory concentration above 1.0 micro g/mL compared with those with more sensitive isolates.
Corneal infection by relatively ciprofloxacin-resistant bacteria responds more slowly to ciprofloxacin therapy. Antibacterial susceptibility testing of corneal cultures may predict the fluoroquinolone therapeutic response rate of bacterial keratitis.
评估角膜分离株对氟喹诺酮类药物的最低抑菌浓度如何影响细菌性角膜炎对氟喹诺酮治疗的临床反应率。
前瞻性队列研究。
663例疑似细菌性角膜炎患者接受诊断性角膜刮片检查，并用0.3%环丙沙星溶液或眼膏局部治疗。在407例培养确诊的细菌性角膜炎患者中，对391例主要角膜分离株对环丙沙星体外敏感的患者评估了环丙沙星单药治疗的改善率和治愈率。
裂隙灯显微镜评估角膜炎症的临床改善情况以及角膜完全上皮化的临床治愈情况。
与分离株较敏感的角膜感染相比，环丙沙星最低抑菌浓度高于1.0μg/mL的角膜感染的调整改善率和治愈率分别降低了43%（95%置信区间，8%，64%）和29%（95%置信区间，0%，49%）。
对环丙沙星相对耐药的细菌引起的角膜感染对环丙沙星治疗的反应较慢。角膜培养物的抗菌药敏试验可预测细菌性角膜炎的氟喹诺酮治疗反应率。
