Friedlaender Mitchell H, Protzko Eugene
Division of Ophthalmology, Scripps Research Institute, Refractive Surgery Program, Scripps Clinic, 1066 N Torrey Pines Rd, La Jolla, CA, USA.
Clin Ophthalmol. 2007 Mar;1(1):3-10.
Conjunctivitis, or inflammation of the conjunctiva, refers to a diverse group of ocular surface diseases of viral or bacterial origin that primarily affect the conjunctiva. In developed countries, the most common causative bacterial pathogens are Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae. Most varieties of conjunctivitis are self-limiting; however, some cases can be extremely contagious or cause serious complications if left unchecked. New ocular antibiotics are needed to keep pace with the increasing incidence of bacterial resistance and provide options that decrease the overall treatment burden and encourage patient compliance. Azithromycin is a well known systemic anti-infective with broad spectrum activity against gram positive-, gram negative-, and atypical bacteria species. Ocular use has been limited because its solubility and stability profiles in aqueous media were not favorable for delivery to the eye. An eyedrop of 1% azithromycin in DuraSite((R)) (AzaSite, InSite Vision, Alameda, CA, USA), a bioadhesive ocular drug delivery system, was recently developed and evaluated in clinical trials. This formulation is well tolerated, delivers a high concentration of azithromycin to the conjunctiva, has a broader eradication profile than aqueous azithromycin, and can be effectively dosed with 7 drops, a 65% reduction in the amount of drops required by the most popular antibiotics currently used for conjunctivitis.
结膜炎，即结膜炎症，指的是一组主要影响结膜的、由病毒或细菌引起的多种眼表疾病。在发达国家，最常见的致病性细菌病原体是金黄色葡萄球菌、流感嗜血杆菌和肺炎链球菌。大多数类型的结膜炎具有自限性；然而，有些病例如果不加以控制，可能具有极强的传染性或引发严重并发症。需要新型眼用抗生素来跟上细菌耐药性不断增加的步伐，并提供能够减轻总体治疗负担并促进患者依从性的选择。阿奇霉素是一种知名的全身抗感染药物，对革兰氏阳性菌、革兰氏阴性菌和非典型细菌具有广谱活性。由于其在水性介质中的溶解度和稳定性不利于眼部给药，其眼部应用一直受到限制。一种含1%阿奇霉素的眼用滴剂（商品名AzaSite，由美国加利福尼亚州阿拉米达市的InSite Vision公司生产，商品名为DuraSite），一种生物黏附性眼部给药系统，最近已被研发并进行了临床试验评估。该制剂耐受性良好，能将高浓度的阿奇霉素递送至结膜，与水性阿奇霉素相比具有更广泛的根除谱，并且只需滴7次即可有效给药，比目前用于治疗结膜炎的最常用抗生素所需的滴数减少了65%。
