Plotas Panagiotis, Makri Olga E, Georgalas Ilias, Pharmakakis Nikolaos, Vantarakis Apostolos, Georgakopoulos Constantine D
a Department of Ophthalmology, Medical School , University of Patras , Patras , Greece.
b Laboratory of Public Health, School of Medicine , University of Patras , Patras , Greece.
Semin Ophthalmol. 2017;32(6):738-742. doi: 10.3109/08820538.2016.1170165. Epub 2016 Aug 3.
This prospective, randomized case series study aims to evaluate the efficacy of ofloxacin 0.3% eye drops in eradication of conjunctival bacterial flora in diabetic patients undergoing intravitreal injections (IVI).
Ninety-two diabetic patients (92 eyes) scheduled to undergo intravitreal injection of ranibizumab due to diabetic macular edema were enrolled in the study. Patients were randomly assigned to three different groups. Group 1 (n=32) received ofloxacin eye drops the day before before IVI (four times); patients in Group 2 (n=29) were administered ofloxacin one hour before IVI (every 15 minutes), while Group 3 (n=31) comprised patients that received combined administration of ofloxacin both one day and one hour before IVI (eight doses). Samples were collected from the injection site before and after antibiotic administration. Culture results from BACTEC broth and positive cultures in blood agar and Sabouraud's dextrose agar plates were measured.
In Group 1, BACTEC broth positive cultures decreased from 84.4% at baseline to 50% after ofloxacin administration (p=0.007), and blood agar positive cultures reduced from 65.63% to 34.38% (p=0.02). In Group 2, positive cultures significantly decreased in BACTEC broth (from 79.3% at baseline to 48.28%; p=0.027) and in blood agar (from 68.97% to 37.13%; p=0.034). In Group 3, positive cultures decreased from 77.42% at baseline to 32.26% (p=0.0008) and from 58.06% at baseline to 22.58% (p=0.009) in BACTEC broth and blood agar, respectively. No microorganisms were isolated from Sabouraud's dextrose agar plates.
The combined one day/one hour (eight doses) ofloxacin administration in diabetic patients is extremely effective in reducing conjunctival bacterial flora. The application of topical ofloxacin for one day or one hour before IVI is also significantly effective.
本前瞻性、随机病例系列研究旨在评估0.3%氧氟沙星滴眼液对接受玻璃体腔内注射（IVI）的糖尿病患者结膜细菌菌群的清除效果。
92例因糖尿病性黄斑水肿计划接受雷珠单抗玻璃体腔内注射的糖尿病患者（92只眼）纳入本研究。患者被随机分为三组。第1组（n = 32）在玻璃体腔内注射前一天使用氧氟沙星滴眼液（4次）；第2组（n = 29）在玻璃体腔内注射前1小时使用氧氟沙星（每15分钟1次），而第3组（n = 31）的患者在玻璃体腔内注射前一天和前1小时联合使用氧氟沙星（8次）。在抗生素给药前后从注射部位采集样本。检测BACTEC肉汤培养结果以及血琼脂和沙氏葡萄糖琼脂平板上的阳性培养物。
在第1组中，BACTEC肉汤阳性培养物从基线时的84.4%降至氧氟沙星给药后的50%（p = 0.007），血琼脂阳性培养物从65.63%降至34.38%（p = 0.02）。在第2组中，BACTEC肉汤和血琼脂中的阳性培养物均显著下降（分别从基线时的79.3%降至48.28%；p = 0.027，从68.97%降至37.13%；p = 0.034）。在第3组中，BACTEC肉汤和血琼脂中的阳性培养物分别从基线时的77.42%降至32.26%（p = 0.0008）和从58.06%降至22.58%（p = 0.009）。在沙氏葡萄糖琼脂平板上未分离到微生物。
糖尿病患者联合一天/一小时（8次）使用氧氟沙星在减少结膜细菌菌群方面极其有效。在玻璃体腔内注射前一天或一小时局部应用氧氟沙星也有显著效果。
