Carron A, Samudio M, Laspina F, Fariña N, Sanabria R R, Cibils D, Ramirez L, Carron J, Mino de Kaspar H
National University of Asunción, Asunción, Paraguay.
Arch Soc Esp Oftalmol. 2013 Sep;88(9):345-51. doi: 10.1016/j.oftal.2013.01.001. Epub 2013 Apr 29.
To determine the efficacy of topical 0.3% ciprofloxacin in reducing conjunctival biota in patients undergoing cataract surgery.
Experimental, prospective, randomized, controlled and single-blind study. Forty-six eyes of 46 patients were randomized into 2 groups, the study group (n=23) received topical 0.3% ciprofloxacin one day before surgery for six times, and on the day of the surgery one drop every 15minutes starting one hour before surgery until 3 doses were completed. The control group (n=23) did not receive any antibiotics. For both groups for the surgical field 10% povidone-iodine was applied. Samples from the conjunctiva were taken at four different times and then cultured on solid media (chocolate agar, blood agar) and enrichment broth (thioglycolate). The aqueous humor samples were also cultured in thioglycolate. The presence of bacteria was identified quantitatively and qualitatively, and the frequency of contamination was measured by considering the presence of bacteria in liquid and solid culture media. The number of colony forming units (CFU) was counted in the solid culture medium.
Positive cultures were obtained in 82.6% and 78.2% of the patients in the study and control groups, respectively, before the administration of 0.3% ciprofloxacin. The administration of 0.3% ciprofloxacin significantly reduced the CFU compared to the control group (P<.05). Immediately after the use of povidone-iodine, the proportion of patients with a positive culture decreased to 21.7% in the study group, and 8.7% in the control group. At the end of the surgery, this percentage was 26% and 30.4%, respectively. The most common isolated pathogen was negative-coagulase Staphylococcus (66.7%).
The administration of 0.3% ciprofloxacin reduces conjunctival bacterial load in the preoperative period. However, it was unable to eradicate the bacteria completely. The administration of povidone-iodine reduced conjunctival biota in 50%-70% of patients undergoing cataract surgery.
确定局部使用0.3%环丙沙星对白内障手术患者结膜微生物群的减少效果。
实验性、前瞻性、随机、对照和单盲研究。46例患者的46只眼随机分为2组，研究组（n=23）在手术前一天局部使用0.3%环丙沙星，共6次，手术当天在术前1小时开始每15分钟滴1次，直至完成3次滴注。对照组（n=23）未使用任何抗生素。两组手术区域均应用10%聚维酮碘。在四个不同时间采集结膜样本，然后在固体培养基（巧克力琼脂、血琼脂）和增菌肉汤（硫乙醇酸盐）上培养。房水样本也在硫乙醇酸盐中培养。对细菌进行定量和定性鉴定，并通过考虑液体和固体培养基中细菌的存在来测量污染频率。在固体培养基中计数菌落形成单位（CFU）数量。
在使用0.3%环丙沙星之前，研究组和对照组分别有82.6%和78.2%的患者培养结果为阳性。与对照组相比，使用0.3%环丙沙星后CFU显著降低（P<0.05）。使用聚维酮碘后，研究组培养结果为阳性的患者比例立即降至21.7%，对照组为8.7%。手术结束时，该比例分别为26%和30.4%。最常见的分离病原体是凝固酶阴性葡萄球菌（66.7%）。
术前使用0.3%环丙沙星可降低结膜细菌载量。然而，它无法完全根除细菌。聚维酮碘的使用使50%-70%的白内障手术患者结膜微生物群减少。
