State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, No. 5 Yanerdao Rd., Qingdao, P.R. China.
J Ocul Pharmacol Ther. 2012 Aug;28(4):420-7. doi: 10.1089/jop.2011.0229. Epub 2012 Feb 23.
The objective of the present study was to evaluate the effectiveness of topically applied gemifloxacin for the treatment of experimental Staphylococcus aureus keratitis in a rabbit model.
Rabbit corneas were intrastromally injected with ~100 colony-forming units (CFU) of S. aureus ATCC25923. Eight hours (early treatment) or 16 h (late treatment) after the injection, 1 topical drop of balanced salt solution (BSS), gemifloxacin ophthalmic solution (0.5%), levofloxacin ophthalmic solution (0.5%), or gatifloxacin eye gel (0.3%) was applied to each eye every 15 min for 5 doses and then, every 30 min for 14 doses. The eyes were examined both before and after treatment. The corneas were harvested from treated and untreated rabbits for the quantitation of bacteria and histological observation.
In the early-treatment groups, all 3 fluoroquinolones significantly lowered the clinical severity of infection and the median erosion area of the cornea compared with the BSS control (P=0.000). In the late-treatment groups, gemifloxacin and levofloxacin did not cause a significant reduction in clinical scores compared with the BSS control (P=0.107 and 0.531, respectively), but the gatifloxacin caused a significant reduction in clinical scores compared with the BSS control (P=0.011). The median erosion area significantly decreased with treatment with gemifloxacin, gatifloxacin, and levofloxacin in both early- and late-treatment groups, when compared with the control group (P≤0.022). In the early-treatment groups, the gemifloxacin, gatifloxacin, and levofloxacin groups had significantly lower CFU recovered from the corneas compared with the control group (P<0.01), while in the late-treatment groups, levofloxacin failed to reduce the CFU recovered from the corneas compared with the control group (P=0.695). The minimal inhibitory concentrations for gemifloxacin, gatifloxacin, and levofloxacin against S. aureus ATCC25923 were 0.0625, 0.0625, and 0.125 mg/L, respectively.
Gemifloxacin, similar to gatifloxacin and levofloxacin, can significantly lower the clinical severity and CFU per cornea observed in S. aureus keratitis when early treatment is implemented. Significantly, gemifloxacin showed a significant efficacy improvement in reducing the bacterial load recovered from the corneas in the late-treatment experiment.
本研究旨在评估局部应用吉米沙星治疗兔金黄色葡萄球菌角膜炎的疗效。
兔角膜基质内注射约 100 个金黄色葡萄球菌 ATCC25923 的集落形成单位（CFU）。注射后 8 小时（早期治疗）或 16 小时（晚期治疗），每只眼每 15 分钟滴 1 滴平衡盐溶液（BSS）、吉米沙星滴眼液（0.5%）、左氧氟沙星滴眼液（0.5%）或加替沙星眼用凝胶（0.3%），共 5 剂，然后每 30 分钟 1 剂，共 14 剂。治疗前后均对眼睛进行检查。从治疗和未治疗的兔子中取出角膜，用于定量细菌和组织学观察。
在早期治疗组中，与 BSS 对照组相比，所有 3 种氟喹诺酮类药物均显著降低了感染的临床严重程度和角膜的平均侵蚀面积（P=0.000）。在晚期治疗组中，与 BSS 对照组相比，吉米沙星和左氧氟沙星的临床评分均无显著降低（P=0.107 和 0.531），但加替沙星的临床评分显著降低（P=0.011）。与对照组相比，无论是早期治疗组还是晚期治疗组，吉米沙星、加替沙星和左氧氟沙星治疗后角膜的平均侵蚀面积均显著降低（P≤0.022）。在早期治疗组中，吉米沙星、加替沙星和左氧氟沙星组从角膜中回收的 CFU 明显低于对照组（P<0.01），而在晚期治疗组中，左氧氟沙星未能降低从角膜中回收的 CFU 与对照组相比（P=0.695）。吉米沙星、加替沙星和左氧氟沙星对金黄色葡萄球菌 ATCC25923 的最小抑菌浓度分别为 0.0625、0.0625 和 0.125mg/L。
吉米沙星与加替沙星和左氧氟沙星类似，在早期治疗时可显著降低金黄色葡萄球菌角膜炎的临床严重程度和角膜 CFU。重要的是，吉米沙星在减少晚期实验中从角膜中回收的细菌负荷方面显示出显著的疗效改善。
