Chen Aiyin, Prajna Lalitha, Srinivasan Muthiah, Mahalakshmi Rajendran, Whitcher John P, McLeod Stephen, Lietman Thomas M, Acharya Nisha R
F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, San Francisco, California 94143, USA.
Am J Ophthalmol. 2008 Mar;145(3):409-412. doi: 10.1016/j.ajo.2007.11.004. Epub 2008 Jan 22.
To determine whether clinical outcomes in bacterial keratitis are associated with antibiotic susceptibility.
Retrospective, ancillary study using data and samples from a completed randomized clinical trial.
Forty-two patients were enrolled with culture-confirmed bacterial keratitis at Aravind Eye Hospital in South India. All patients received topical moxifloxacin and were randomized to receive either topical prednisolone phosphate or placebo. Outcomes included time to epithelialization, best spectacle-corrected visual acuity (BSCVA), and infiltrate/scar size at three months. Bacterial isolates were cultured, and minimum inhibitory concentration (MIC) to moxifloxacin was measured using Etests. Multiple linear regression was used to assess the effect of MIC on outcome, adjusting for enrollment characteristics.
MIC was associated with three-month infiltrate/scar size: each two-fold increase in MIC was associated with a 0.33-mm average diameter increase in scar size (P=.01). MIC was not associated with three-month BSCVA (P=.71) or time to epithelialization (P=.35).
MIC was associated with infiltrate/scar size in bacterial keratitis. An ongoing larger, multicenter trial should provide further information on whether this association is maintained across subgroups of organisms.
确定细菌性角膜炎的临床结局是否与抗生素敏感性相关。
采用来自一项已完成的随机临床试验的数据和样本进行回顾性辅助研究。
印度南部阿拉文德眼科医院纳入了42例经培养确诊的细菌性角膜炎患者。所有患者均接受局部莫西沙星治疗，并随机分为接受局部磷酸泼尼松龙或安慰剂治疗。结局指标包括上皮化时间、最佳矫正视力（BSCVA）以及三个月时的浸润/瘢痕大小。对细菌分离株进行培养，并使用Etest测定对莫西沙星的最低抑菌浓度（MIC）。采用多元线性回归评估MIC对结局的影响，并对纳入特征进行校正。
MIC与三个月时的浸润/瘢痕大小相关：MIC每增加两倍，瘢痕大小平均直径增加0.33 mm（P = 0.01）。MIC与三个月时的BSCVA（P = 0.71）或上皮化时间（P = 0.35）无关。
MIC与细菌性角膜炎的浸润/瘢痕大小相关。一项正在进行的更大规模的多中心试验应能提供进一步信息，以确定这种关联在不同微生物亚组中是否依然存在。
