Nejima Ryohei, Shimizu Kimiya, Ono Takashi, Noguchi Yukari, Yagi Akiko, Iwasaki Takuya, Shoji Nobuyuki, Miyata Kazunori
From the Departments of Ophthalmology, Miyata Eye Hospital (Nejima, Ono, Noguchi, Yagi, Iwasaki, Miyata), Miyakonojyo, International University of Health and Welfare (Shimizu), Chiba, and School of Medicine (Nejima, Shoji), Kitasato University, Sagamihara, Japan.
From the Departments of Ophthalmology, Miyata Eye Hospital (Nejima, Ono, Noguchi, Yagi, Iwasaki, Miyata), Miyakonojyo, International University of Health and Welfare (Shimizu), Chiba, and School of Medicine (Nejima, Shoji), Kitasato University, Sagamihara, Japan.
J Cataract Refract Surg. 2017 Jan;43(1):42-48. doi: 10.1016/j.jcrs.2016.10.024.
To assess the long-term and short-term effects of post-cataract surgery antibiotic therapy on the drug-resistance profile of normal conjunctival bacterial flora.
Miyata Eye Hospital, Miyazaki, Japan.
Randomized prospective clinical trial.
Patients aged 20 years or older who had cataract surgery between May and September 2015 were given levofloxacin 1.5% ophthalmic solution for 3 days preoperatively. The patients were randomly assigned to a 1-week postoperative group or a 1-month postoperative group according to postoperative administration duration. Conjunctival sacs were scraped for bacterial culturing before administration, 1 week postoperatively, at the completion of administration, and 1, 3, and 6 months after administration completion. The bacterial culture growth and minimum inhibitory concentrations (MICs) of levofloxacin against recovered strains of Staphylococcus epidermidis were assessed.
The study enrolled 104 patients. The MICs of levofloxacin against S epidermidis increased during levofloxacin administration compared with before administration in both groups and then declined after administration completion. However, by 3 months, the MICs in the 1-month group were approximately twice those in the 1-week group. Antibiotic susceptibility before administration, at completion of administration, and at 3 months was 73.6%, 20.2%, and 38.5%, respectively, in the 1-week group and 63.0%, 0.0%, and 19.3%, respectively, in the 1-month group. The results indicate that from completion of administration to 3 months, the susceptible strains were approximately 20% lower in the 1-month postoperative group than in the 1-week postoperative group.
Administration duration of perioperative levofloxacin 1.5% influenced the MICs and susceptibility of S epidermidis isolated from the conjunctival sac.
评估白内障手术后抗生素治疗对正常结膜细菌菌群耐药性的长期和短期影响。
日本宫崎县宫田眼科医院。
随机前瞻性临床试验。
年龄在20岁及以上、于2015年5月至9月期间接受白内障手术的患者，术前3天给予1.5%左氧氟沙星滴眼液。根据术后给药持续时间，将患者随机分为术后1周组或术后1个月组。在给药前、术后1周、给药结束时以及给药结束后1、3和6个月刮取结膜囊进行细菌培养。评估左氧氟沙星对表皮葡萄球菌分离株的细菌培养生长情况和最低抑菌浓度（MIC）。
该研究纳入了104例患者。两组中，左氧氟沙星给药期间表皮葡萄球菌对左氧氟沙星的MIC与给药前相比均升高，给药结束后下降。然而，到3个月时，1个月组的MIC约为1周组的两倍。1周组给药前、给药结束时和3个月时的抗生素敏感性分别为73.6%、20.2%和38.5%，1个月组分别为63.0%、0.0%和19.3%。结果表明，从给药结束到3个月，术后1个月组的敏感菌株比术后1周组低约20%。
围手术期使用1.5%左氧氟沙星的给药持续时间影响了从结膜囊中分离出的表皮葡萄球菌的MIC和敏感性。
