Silbiger J, Stern G A
Department of Ophthalmology, University of Florida College of Medicine, Gainesville 32610-0284.
Ophthalmology. 1992 Jun;99(6):889-92. doi: 10.1016/s0161-6420(92)31877-9.
To clarify the role of corneal collagen shields as a drug delivery device for the treatment of bacterial keratitis, the authors studied the effectiveness of topical gentamicin treatment, with and without the use of corneal collagen shields, in a rabbit model of Pseudomonas keratitis.
Forty-eight New Zealand white rabbits were infected by injecting 500 colony-forming units (CFU) of Pseudomonas aeruginosa into the corneal stroma, and treatment was begun 24 hours later. A 13.6 mg/ml solution of gentamicin was topically administered during a 24-hour period. Collagen shields were soaked in gentamicin 13.6 mg/ml for 5 minutes before placing them on the cornea. Corneas were quantitatively cultured 1 hour after the treatment period ended. Six different groups of rabbits were tested, with the results analyzed as the mean log10 of bacterial CFU.
An untreated control group had significantly more bacteria (7.96 +/- 0.74) than any of 5 treatment groups. No difference was found between groups given a loading dose of antibiotic drops at the beginning of treatment, either with (4.90 +/- 2.41) or without (6.25 +/- 0.54) an antibiotic-impregnated collagen shield. A group treated with a collagen shield augmented with gentamicin drops every 3 hours had fewer bacteria (1.52 +/- 1.82) than a group receiving drops alone (4.15 +/- 1.83) (P less than 0.05). However, treatment with a collagen shield supplemented with drops every 3 hours was not as effective as gentamicin drops administered every 30 minutes (no bacterial growth) (P less than 0.05).
These results show that antibiotic-impregnated collagen shields should not replace traditional antibiotic drop therapy as the mainstay of treatment but may be a useful adjunct to treatment with topical antibiotics.
为阐明角膜胶原盾作为治疗细菌性角膜炎的药物递送装置的作用，作者在铜绿假单胞菌性角膜炎的兔模型中研究了局部应用庆大霉素治疗（使用和不使用角膜胶原盾）的有效性。
将500个铜绿假单胞菌菌落形成单位（CFU）注射到48只新西兰白兔的角膜基质中进行感染，24小时后开始治疗。在24小时内局部给予13.6mg/ml的庆大霉素溶液。将胶原盾在13.6mg/ml的庆大霉素中浸泡5分钟后置于角膜上。治疗期结束1小时后对角膜进行定量培养。对六组不同的兔子进行测试，结果以细菌CFU的平均log10进行分析。
未治疗的对照组细菌数量（7.96±0.74）明显多于5个治疗组中的任何一组。在治疗开始时给予抗生素滴眼液负荷剂量的组之间没有差异，无论是否使用（4.90±2.41）抗生素浸渍的胶原盾（6.25±0.54）。每3小时用庆大霉素滴眼液增强的胶原盾治疗组的细菌数量（1.52±1.82）少于仅接受滴眼液的组（4.15±1.83）（P＜0.05）。然而，每3小时补充滴眼液的胶原盾治疗不如每30分钟给予庆大霉素滴眼液有效（无细菌生长）（P＜0.05）。
这些结果表明，抗生素浸渍的胶原盾不应取代传统的抗生素滴眼液治疗作为主要治疗方法，但可能是局部抗生素治疗的有用辅助手段。
