Yactayo-Miranda Yazmin, Ta Christopher N, He Lisa, Kreutzer Thomas C, Nentwich Martin M, Kampik Anselm, Mino de Kaspar Herminia
Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
Graefes Arch Clin Exp Ophthalmol. 2009 Jul;247(7):993-8. doi: 10.1007/s00417-009-1039-0. Epub 2009 Feb 11.
To determine the efficacy of conjunctival bacterial eradication following a 1-day, 3-day and 7-day application of topical 0.5% levofloxacin, with and without eyelid scrub, in patients with chronic blepharoconjunctivitis (CBC).
Patients with CBC (n = 60) were prospectively randomized to three groups (n = 20 in each group): no antibiotic treatment, topical levofloxacin four times per day in both eyes, and eyelid scrub in addition to topical levovofloxacin four times a day in both eyes. Patients without CBC (n = 40) were enrolled as the negative control group. Cultures of the conjunctiva were obtained from both eyes at baseline, 1 day, 3 days, and 7 days following treatment.
The most common bacteria isolated for all groups at baseline were coagulase-negative Staphylococcus. Eight patients did not complete the study. The remaining 52 patients with CBC had a significantly higher rate of positive thioglycolate broth cultures (94%) compared to a 58% positive culture rate in patient without CBC (P < 0.0001). Treatment with at least 3 days of topical antibiotic in patient with CBC resulted in a significant reduction (P < 0.05) in the number of thioglycolate positive cultures (<or= 60%) compared to non-treated eyes (>or= 88%). Following a minimum of a 1-day application of antibiotic, the median colony-forming unit was 0-1 compared to 3-8 for eyes without antibiotic treatment (P < 0.05). Scrubbing of the eyelids did not provide further benefit compared to antibiotic treatment alone.
CBC eyes have a significantly higher number of positive cultures than eyes without CBC. The application of topical 0.5% levofloxacin for at least 3 days provided a significant reduction in the number of positive cultures as well as the number of bacteria harbored on the conjunctival surface.
为确定在慢性睑结膜炎（CBC）患者中，应用0.5%左氧氟沙星滴眼液1天、3天和7天，无论有无眼睑擦洗，结膜细菌根除的疗效。
将CBC患者（n = 60）前瞻性随机分为三组（每组n = 20）：不进行抗生素治疗、双眼每天4次局部应用左氧氟沙星、双眼每天4次局部应用左氧氟沙星并进行眼睑擦洗。将非CBC患者（n = 40）纳入阴性对照组。在治疗前基线、治疗后1天、3天和7天从双眼获取结膜培养物。
所有组在基线时分离出的最常见细菌是凝固酶阴性葡萄球菌。8名患者未完成研究。其余52例CBC患者硫乙醇酸盐肉汤培养阳性率（94%）显著高于非CBC患者的阳性培养率（58%）（P < 0.0001）。与未治疗的眼睛（≥88%）相比，CBC患者至少使用3天局部抗生素治疗后，硫乙醇酸盐阳性培养物数量显著减少（P < 0.05）（≤60%）。至少应用1天抗生素后，菌落形成单位中位数为0 - 1，而未用抗生素治疗的眼睛为3 - 8（P < 0.05）。与单独使用抗生素治疗相比，眼睑擦洗未提供进一步益处。
CBC患者眼睛的阳性培养物数量显著高于非CBC患者眼睛。局部应用0.5%左氧氟沙星至少3天可显著减少阳性培养物数量以及结膜表面携带的细菌数量。
