Schilling Brennan, Hii Michael, Shanks Hazel Q, Romanowski Eric G, Mandell Jonathan B, Shanks Robert M Q, Zegans Michael
Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
The Charles T. Campbell Ophthalmic Microbiology Laboratory, Department of Ophthalmology, University of Pittsburgh School of Medicine, 1622 Locust St., Pittsburgh, PA 15219, USA.
Antibiotics (Basel). 2024 Dec 23;13(12):1236. doi: 10.3390/antibiotics13121236.
Endophthalmitis is an intraocular microbial infection that can lead to permanent blindness, even with prompt anti-microbial therapy. Multi-drug-resistant organisms are on the rise, potentially limiting the efficacy of current empiric antibiotic therapies of intravitreal ceftazidime and vancomycin. Cefiderocol is a recent FDA- and EMA-approved antibiotic for multi-drug-resistant Gram-negative bacteria. To better understand its potential utility in the treatment of ocular infections, the MIC of cefiderocol was compared to ceftazidime and amikacin in endophthalmitis bacterial isolates using Epsilometer testing. Because vancomycin is commonly given concomitantly as part of empiric endophthalmitis treatment, possible synergistic and antagonistic effects of concomitant vancomycin and cefiderocol were also evaluated. Cefiderocol was found to have lower MIC values compared to ceftazidime for or species. When comparing the MICs of cefiderocol and vancomycin, there appeared to be no antagonism between the two antibiotics. This is the first report exploring the use of cefiderocol in endophthalmitis strains. The results of this study show this is a promising antibiotic for multi-drug-resistant Gram-negative organisms but further research is needed to investigate its intraocular safety profile.
眼内炎是一种眼内微生物感染，即使及时进行抗微生物治疗，也可能导致永久性失明。耐多药微生物正在增加，这可能会限制目前玻璃体内注射头孢他啶和万古霉素的经验性抗生素治疗的疗效。头孢地尔是一种最近获得美国食品药品监督管理局（FDA）和欧洲药品管理局（EMA）批准用于治疗耐多药革兰氏阴性菌的抗生素。为了更好地了解其在治疗眼部感染中的潜在效用，使用Epsilometer试验比较了头孢地尔与头孢他啶和阿米卡星在眼内炎细菌分离株中的最低抑菌浓度（MIC）。由于万古霉素通常作为眼内炎经验性治疗的一部分同时使用，因此还评估了万古霉素与头孢地尔同时使用时可能产生的协同和拮抗作用。结果发现，对于[具体物种1]或[具体物种2]，头孢地尔的MIC值低于头孢他啶。在比较头孢地尔和万古霉素的MIC时，这两种抗生素之间似乎没有拮抗作用。这是第一份探索头孢地尔在眼内炎菌株中应用的报告。本研究结果表明，这是一种治疗耐多药革兰氏阴性菌的有前景的抗生素，但需要进一步研究以调查其眼内安全性。
