Helm C J, Holland G N, Lin R, Berlin O G, Bruckner D A
UCLA Ocular Inflammatory Disease Center.
Am J Ophthalmol. 1993 Dec 15;116(6):700-7. doi: 10.1016/s0002-9394(14)73469-5.
The efficacy of three topical antibiotic treatments for Mycobacterium fortuitum (strain ATCC-6841) keratitis were compared in rabbits. Rabbits were treated with ciprofloxacin (3 mg/ml) or clarithromycin (20 mg/ml) or a combination of amikacin (100 mg/ml) and vancomycin (50 mg/ml). All three treatments significantly reduced the number of organisms in treated eyes compared to untreated, control eyes (all P values < .001). No significant difference in treatment efficacy was found between the three treatment groups (all P values > or = .48), although ciprofloxacin (3 mg/ml) was more effective than clarithromycin (20 mg/ml) after excluding outliers (P = .01). All treatments stabilized or reduced the size of stromal infiltrates after four days of therapy, whereas infiltrates continued to enlarge in untreated eyes. These results suggest that topical clarithromycin, topical ciprofloxacin, and combined amikacin and vancomycin may all be clinically useful for treating M. fortuitum keratitis. Both clarithromycin and ciprofloxacin were better tolerated than combined amikacin and vancomycin. This study supports the further development of clarithromycin, a new macrolide antibiotic, as a topical drug for treatment of M. fortuitum keratitis.
在兔中比较了三种局部用抗生素治疗偶然分枝杆菌（菌株ATCC - 6841）角膜炎的疗效。兔分别用环丙沙星（3mg/ml）、克拉霉素（20mg/ml）或阿米卡星（100mg/ml）与万古霉素（50mg/ml）的联合制剂进行治疗。与未治疗的对照眼相比，所有三种治疗均显著减少了治疗眼内的菌量（所有P值<0.001）。三个治疗组之间未发现治疗效果有显著差异（所有P值≥0.48），尽管在排除异常值后环丙沙星（3mg/ml）比克拉霉素（20mg/ml）更有效（P = 0.01）。治疗四天后，所有治疗均使基质浸润灶的大小稳定或缩小，而未治疗的眼内浸润灶继续扩大。这些结果表明，局部用克拉霉素、局部用环丙沙星以及阿米卡星与万古霉素联合制剂可能在临床上均对治疗偶然分枝杆菌角膜炎有用。克拉霉素和环丙沙星的耐受性均优于阿米卡星与万古霉素联合制剂。本研究支持进一步开发新型大环内酯类抗生素克拉霉素作为治疗偶然分枝杆菌角膜炎的局部用药。
