Teberik Kuddusi, Eski Mehmet Tahir, Çalışkan Emel, Kılınçel Özge, Kaya Murat, Ankaralı Handan
Department of Ophthalmology, Faculty of Medicine, Düzce University, Düzce, Turkey.
Department of Ophthalmology, Ministry of Health Bingöl State Hospital, Bingöl, Turkey.
Arq Bras Oftalmol. 2019 Jan-Feb;82(1):25-31. doi: 10.5935/0004-2749.20190008.
To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection.
A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation.
The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217).
Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.
比较5%聚维酮碘与预防性局部使用阿奇霉素和莫西沙星对接受玻璃体腔内注射患者细菌菌群的影响。
总共132例患者被随机分配接受阿奇霉素或莫西沙星治疗，或不接受治疗（对照组）。总共在入院时、玻璃体腔内注射前4天、玻璃体腔内注射后4天和玻璃体腔内注射后8天获取528份标本。样本立即送往微生物实验室进行培养。
最常观察到的微生物是凝固酶阴性葡萄球菌（23.8%）。在评估注射前第4天获得的样本结果时，与对照组相比，莫西沙星组凝固酶阴性葡萄球菌的生长显著降低（p=0.049）。给予阿奇霉素后鲍曼不动杆菌继续生长（p=0.033）。在评估玻璃体腔内注射后4天的结果时，与接受阿奇霉素或莫西沙星治疗的患者相比，对照组凝固酶阴性葡萄球菌的生长更高（p=0.004）。莫西沙星组的根除率显著高于对照组（p=0.001）。玻璃体腔内注射后第8天获得的样本显示所有组的细菌生长水平相似（p=0.217）。
莫西沙星在控制结膜细菌菌群生长方面比5%聚维酮碘更有效。莫西沙星与5%聚维酮碘联合使用产生协同效应。
