Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Ocul Pharmacol Ther. 2013 Apr;29(3):339-44. doi: 10.1089/jop.2012.0081. Epub 2013 Jan 4.
Besifloxacin is a novel fluoroquinolone antibiotic developed to provide alternative coverage for ocular pathogens with current and emerging in vitro and in vivo resistance to present fluoroquinolones and other commonly dispensed ocular antibiotics. The purpose of this study was to investigate the in vitro efficacy of besifloxacin and 7 comparators against ciprofloxacin- and methicillin-susceptible and nonsusceptible staphylococcal isolates from conjunctivitis, blepharitiis, keratitis, endophthalmitis, and other ocular surface disorders.
Nonconsecutive ocular Staphylococcus aureus (N=154) and Coagulase-negative Staphylococcus (N=89, including 84 Staphylococcus epidermidis) isolates collected from patients presenting during the 6 years (2003-2008) were evaluated using frozen minimal inhibitory concentration (MIC) panels containing serial dilutions (μg/mL) of besifloxacin (0.004-32), moxifloxacin (0.004-128), ciprofloxacin (0.03-256), azithromycin (0.12-128), oxacillin (0.03-32), gentamicin (0.03-128), trimethoprim (0.5-16), and vancomycin (0.12-32).
Among the fluoroquinolones group, besifloxacin had the lowest MIC90s. MIC90 values (μg/mL) for besifloxacin (4) was 8-fold lower than for moxifloxacin (32) and 32-fold lower than ciprofloxacin (128). Among the nonfluoroquinolone comparators, vancomycin (2) had the lowest MICs followed by gentamicin (16) and trimethoprim (16). Besifloxacin MIC90s (μg/mL) were lowest for isolates recovered from the lacrimal sac (0.25), followed by lids (1), conjunctiva (2), keratitis (4), and intraocular fluids (4).
Due to its improved coverage for ciprofloxacin- and methicillin-resistant staphylococci, besifloxacin may offer extended coverage for some ocular pathogens resistant to current fluoroquinolones recovered from a diverse group of ocular sources. Ninety-five percent of all isolates were covered by a besifloxacin MIC90 of 4 μg/mL.
贝西沙星是一种新型氟喹诺酮类抗生素，旨在为当前氟喹诺酮类药物和其他常用眼部抗生素对眼表病原体的体外和体内耐药性提供替代覆盖。本研究旨在研究贝西沙星和 7 种对照药物对来自结膜炎、睑缘炎、角膜炎、眼内炎和其他眼表疾病的耐环丙沙星和耐甲氧西林金黄色葡萄球菌分离株的体外疗效。
使用包含贝西沙星（0.004-32μg/ml）、莫西沙星（0.004-128μg/ml）、环丙沙星（0.03-256μg/ml）、阿奇霉素（0.12-128μg/ml）、苯唑西林（0.03-32μg/ml）、庆大霉素（0.03-128μg/ml）、甲氧苄啶（0.5-16μg/ml）和万古霉素（0.12-32μg/ml）的连续稀释冻存最小抑菌浓度（MIC）板评估了 6 年内（2003-2008 年）从就诊患者中收集的非连续眼部金黄色葡萄球菌（N=154）和凝固酶阴性葡萄球菌（N=89，包括 84 株表皮葡萄球菌）分离株。
在氟喹诺酮类药物组中，贝西沙星的 MIC90 最低。贝西沙星（4μg/ml）的 MIC90 值比莫西沙星（32μg/ml）低 8 倍，比环丙沙星（128μg/ml）低 32 倍。在非氟喹诺酮类对照药物中，万古霉素（2μg/ml）的 MIC 最低，其次是庆大霉素（16μg/ml）和甲氧苄啶（16μg/ml）。贝西沙星的 MIC90（μg/ml）对从泪囊（0.25）中分离的分离株最低，其次是眼睑（1）、结膜（2）、角膜炎（4）和眼内液（4）。
由于其对环丙沙星和耐甲氧西林金黄色葡萄球菌的覆盖范围有所改善，贝西沙星可能为从多种眼部来源获得的对当前氟喹诺酮类药物耐药的一些眼部病原体提供了更广泛的覆盖范围。所有分离株中有 95%被贝西沙星 MIC90 为 4μg/ml 所覆盖。
