He Lingmin, Ta Christopher N, Miño de Kaspar Herminia
Department of Ophthalmology, School of Medicine, Stanford University, Stanford, California 94304, USA.
J Cataract Refract Surg. 2009 Oct;35(10):1715-8. doi: 10.1016/j.jcrs.2009.04.042.
To compare selection for fluoroquinolone-resistant bacteria between 1-day and 3-day application of topical moxifloxacin 0.5%.
Department of Ophthalmology, Stanford University, Stanford, California, USA.
After investigative review board approval, patients scheduled for ocular surgery were randomized to receive topical moxifloxacin 0.5% drops 4 times a day for 1 day or 3 days preoperatively. Conjunctival cultures were obtained at baseline and after antibiotic application. Bacteria were identified and tested for resistance to a battery of antibiotic agents using the Kirby-Bauer disk-diffusion method. The differences in resistance distributions for the most commonly isolated bacteria between baseline (T0) and after antibiotic administration (T1) were compared between the 2 treatment groups.
Coagulase-negative Staphylococcus (CNS) were the most common bacteria isolated at T0 and T1. At T0, the proportion of CNS isolated in the 1-day group (n = 63) that was resistant to fluoroquinolones ranged from 4% to 22% depending on the antibiotic agent tested. After 1-day treatment with moxifloxacin, the percentage of resistant bacteria increased significantly (range 13% to 67%) for all fluoroquinolones except gatifloxacin (P<.05). Resistance to gentamicin and tobramycin also increased significantly. However, patients treated for 3 days (n = 57) showed no differences in bacterial resistance rates to any antibiotic agent tested.
Prophylactic topical moxifloxacin 0.5% treatment starting 1 day before ocular surgery resulted in a significant increase in fluoroquinolone-resistant bacteria, while a 3-day antibiotic regimen did not select for resistant organisms.
比较局部应用0.5%莫西沙星1天与3天对耐氟喹诺酮类细菌的选择情况。
美国加利福尼亚州斯坦福大学眼科系。
经调查审查委员会批准，计划进行眼科手术的患者被随机分为两组，分别在术前1天或3天每天4次局部滴用0.5%莫西沙星滴眼液。在基线期和应用抗生素后获取结膜培养物。使用 Kirby-Bauer 纸片扩散法鉴定细菌并检测其对一系列抗生素的耐药性。比较两个治疗组在基线期（T0）和抗生素给药后（T1）最常分离出的细菌耐药性分布差异。
凝固酶阴性葡萄球菌（CNS）是在T0和T1分离出的最常见细菌。在T0时，1天组（n = 63）中分离出的对氟喹诺酮类耐药的CNS比例根据所测试的抗生素不同，在4%至22%之间。用莫西沙星治疗1天后，除加替沙星外，所有氟喹诺酮类药物的耐药菌百分比均显著增加（范围为13%至67%）（P<0.05）。对庆大霉素和妥布霉素的耐药性也显著增加。然而，接受3天治疗的患者（n = 57）对任何测试抗生素的细菌耐药率均无差异。
眼科手术前1天开始预防性局部应用0.5%莫西沙星治疗会导致耐氟喹诺酮类细菌显著增加，而3天抗生素方案不会选择出耐药菌。
