Gray T B, Keenan J I, Clemett R S, Allardyce R A
Department of Ophthalmology, Christchurch School of Medicine, New Zealand.
Aust N Z J Ophthalmol. 1993 May;21(2):99-103. doi: 10.1111/j.1442-9071.1993.tb00761.x.
In a placebo-controlled, randomised, double-blind clinical trial, the authors evaluated the efficacy of patient-administered 1% fusidic acid viscous eye drops in clearing the commonest organisms causing pseudophakic endophthalmitis (Staphylococcus epidermidis and aureus) from the lids and conjunctivae of 79 patients before cataract surgery. The treatment group self-administered fusidic acid viscous eye drops four times daily for seven days before surgery; the placebo group received inert ophthalmic drops. Fellow eyes of both groups remained untreated as a natural control. Lower fornix and lid margin cultures were taken from both eyes before and after treatment. Before treatment, there was no statistical difference in organism counts between the groups. After treatment, eyes receiving fusidic acid were more likely to be free of clinically relevant Staphylococcus spp. than all pre-treatment eyes (for lids, P << 0.001; conjunctivae, P = 0.02). A highly significant (P < 0.001) number of lid margins were rendered 'clinically clean' (i.e., 0-49 organisms/swab) by fusidic acid when compared with untreated eyes. Treatment also effectively (P < 0.05) reduced the numbers of bacteria isolated from conjunctivae. This study indicates that there is a highly significant reduction of Staphylococcus spp. (P << 0.001), non-Staphylococcus spp. (P << 0.001) and attainment of sterile eyes (P << 0.001) at operation gained by patient self-administration of 1% fusidic acid four times daily for seven days before surgery.
在一项安慰剂对照、随机、双盲临床试验中，作者评估了患者自行使用1%夫西地酸粘性滴眼液，在白内障手术前清除79例患者眼睑和结膜上引起人工晶状体眼内炎的最常见病原体（表皮葡萄球菌和金黄色葡萄球菌）的疗效。治疗组在手术前7天每天自行使用夫西地酸粘性滴眼液4次；安慰剂组接受惰性眼药水。两组的对侧眼均未治疗作为自然对照。在治疗前后从双眼采集下穹窿和睑缘培养物。治疗前，两组间病原体计数无统计学差异。治疗后，接受夫西地酸治疗的眼睛比所有治疗前的眼睛更有可能没有临床相关的葡萄球菌属（眼睑，P << 0.001；结膜，P = 0.02）。与未治疗的眼睛相比，夫西地酸使大量（P < 0.001）睑缘达到“临床清洁”（即每拭子0 - 49个病原体）。治疗还有效（P < 0.05）减少了从结膜分离出的细菌数量。这项研究表明，术前7天每天4次自行使用1%夫西地酸，可使手术时葡萄球菌属（P << 0.001）、非葡萄球菌属（P << 0.001）显著减少，且无菌眼的比例显著提高（P << 0.001）。
