Dallison I W, Simpson A J, Keenan J I, Clemett R S, Allardyce R A
Department of Ophthalmology, Christchurch School of Medicine, New Zealand.
Aust N Z J Ophthalmol. 1989 Aug;17(3):289-93. doi: 10.1111/j.1442-9071.1989.tb00535.x.
The effectiveness of topical fusidic acid 1%, in a viscous drop base, to reduce or eliminate ocular microflora in patients undergoing cataract surgery has been studied. Forty-two patients received fusidic acid on a double-blind basis and for comparison 21 patients were similarly assessed with topical chloramphenicol. A further 17 patients received no treatment other than subconjunctival cephazolin administered to all operated eyes at the time of surgery. Quantitative bacterial counts from the conjunctivae and lash lines of each patient were made 24 hours before surgery, on the morning of operation and again 48 hours after surgery. With a regimen of five administrations on the day prior to surgery, neither topical fusidic acid 1.0% nor chloramphenicol 0.5% produced clinically or statistically significant reductions of the ocular microflora. In contrast perioperative subconjunctival cephazolin effectively reduced or eliminated lid and conjunctival microflora following surgery. This study indicates that the effectiveness of a topical antibiotic preparation for overt ocular infection cannot be directly extrapolated to the effect on resident ocular microflora, at least with short-term use for presurgical prophylaxis.
已对含1%夫西地酸的粘性滴眼剂在白内障手术患者中减少或消除眼部微生物群的有效性进行了研究。42例患者接受双盲法夫西地酸治疗，作为对照，21例患者接受局部氯霉素治疗并进行类似评估。另有17例患者除在手术时对所有手术眼结膜下注射头孢唑林外未接受其他治疗。在手术前24小时、手术当天上午以及手术后48小时对每位患者的结膜和睫毛线进行细菌定量计数。在手术前一天进行五次给药的方案下，1.0%的夫西地酸滴眼液和0.5%的氯霉素滴眼液均未使眼部微生物群产生临床上或统计学上的显著减少。相比之下，围手术期结膜下注射头孢唑林可有效减少或消除术后眼睑和结膜的微生物群。本研究表明，局部抗生素制剂对明显眼部感染的有效性不能直接外推至对眼部常驻微生物群的影响，至少在短期用于术前预防时如此。
