Callegan M C, Engel L S, Clinch T E, Hill J M, Kaufman H E, O'Callaghan R J
Department of Microbiology, Immunology and Parasitology, Louisiana State University Medical Center School of Medicine, New Orleans 70112.
Curr Eye Res. 1994 Dec;13(12):875-8. doi: 10.3109/02713689409015089.
Treatment of staphylococcal keratitis includes tobramycin drops at repeated intervals, a prolonged therapy that is disruptive to the patient. To identify a regimen involving less frequent drug application, we compared the efficacy of fortified tobramycin (1.36%) administered by collagen shields or in topical drop form to rabbit corneas intrastromally infected with staphylococci. Eyes were treated with shields hydrated in and supplemented with fortified tobramycin drops (1.36%) applied every 1, 2, 5, or 10 h, from 10 to 20 h postinfection. For topical drop treatment alone, tobramycin was applied following the identical regimen. Untreated corneas contained 10(6) colony forming units. Shields supplemented with tobramycin drops applied every 1, 2, or 5 h sterilized 100% of the corneas. Shields supplemented with tobramycin drops applied at 10 h sterilized 58% of the corneas. Topical delivery of tobramycin every h sterilized all corneas; drops alone applied at longer intervals, such as 2, 5, or 10 h, sterilized 83%, 17%, and 0% of the corneas, respectively. Collagen shield delivery of tobramycin with supplemental topical drops can eradicate staphylococci in this model with less frequent dosing intervals than are required with topical therapy alone.
葡萄球菌性角膜炎的治疗包括反复使用妥布霉素滴眼液，这种长期治疗对患者来说很麻烦。为了确定一种用药频率较低的治疗方案，我们比较了通过胶原盾或局部滴眼形式给予的强化妥布霉素（1.36%）对感染葡萄球菌的兔角膜基质内注射的疗效。在感染后10至20小时，用在强化妥布霉素滴眼液（1.36%）中保湿并补充该滴眼液的胶原盾对眼睛进行治疗，每1、2、5或10小时给药一次。对于仅局部滴眼治疗，妥布霉素按照相同方案给药。未治疗的角膜含有10⁶个菌落形成单位。每1、2或5小时补充妥布霉素滴眼液的胶原盾使100%的角膜灭菌。每10小时补充妥布霉素滴眼液的胶原盾使58%的角膜灭菌。每小时局部给予妥布霉素使所有角膜灭菌；单独滴眼且给药间隔较长，如2、5或10小时，分别使83%、17%和0%的角膜灭菌。在该模型中，通过胶原盾给予妥布霉素并辅以局部滴眼，与单独局部治疗相比，给药间隔频率更低就能根除葡萄球菌。
