Moreau J M, Green L C, Engel L S, Hill J M, O'Callaghan R J
Department of Microbiology, Immunology, and Parasitology, LSU Medical Center, New Orleans, LA 70112-1393, USA.
Curr Eye Res. 1998 Aug;17(8):808-12.
Staphylococcus aureus causes severe corneal infections that often result in corneal scarring and blindness. Presently, therapy often involves the use of a fluoroquinolone antibiotic. This study, employing an experimental rabbit model of Staphylococcus keratitis, compared the effectiveness of two commonly prescribed formulations of fluoroquinolones to an experimental formulation, ciprofloxacin with polystyrene sulfonate (ciprofloxacin-PSS). The ciprofloxacin-PSS formulation uses an ion exchange resin to aid in the delivery of drug to the cornea.
Early (4-9 h postinfection, PI) and late (10-15 h PI) therapies were studied, employing 5 groups: ciprofloxacin-PSS, ciprofloxacin, ofloxacin, PSS vehicle. and untreated. Dosing regimens were: every 30 min, 60 min, or a single drop applied at 9 h PI. Eyes were observed by slit lamp examination (SLE) and bacterial colony forming units (CFU) per cornea were determined.
Early phase therapy with ciprofloxacin-PSS, ciprofloxacin, or ofloxacin administered every 30 or 60 min were equally effective (P > or = 0.2880), decreasing CFU per cornea by >5 log. Ciprofloxacin was significantly more active than ciprofloxacin-PSS or ofloxacin (P < or = 0.0410) when applied as a single drop. Late therapy with ciprofloxacin-PSS, ciprofloxacin, or ofloxacin administered every 30 or 60 min resulted in >3 log decrease in CFU per cornea relative to controls (P < or = 0.0001).
Topical treatment of experimental Staphylococcus keratitis with ciprofloxacin-PSS, ciprofloxacin, or ofloxacin was effective. The effectiveness of ciprofloxacin-PSS suggests that improved drug delivery systems employing an ion exchange resin could be useful in an ocular fluoroquinolone formulation.
金黄色葡萄球菌可引起严重的角膜感染，常导致角膜瘢痕形成和失明。目前，治疗通常使用氟喹诺酮类抗生素。本研究采用金黄色葡萄球菌角膜炎实验兔模型，比较了两种常用的氟喹诺酮类制剂与一种实验制剂环丙沙星聚苯乙烯磺酸盐（环丙沙星-PSS）的有效性。环丙沙星-PSS制剂使用离子交换树脂来辅助药物输送到角膜。
研究了早期（感染后4-9小时，PI）和晚期（感染后10-15小时，PI）治疗，分为5组：环丙沙星-PSS、环丙沙星、氧氟沙星、PSS载体和未治疗组。给药方案为：每30分钟、60分钟给药，或在感染后9小时单次滴眼。通过裂隙灯检查（SLE）观察眼睛，并测定每只角膜的细菌菌落形成单位（CFU）。
早期用环丙沙星-PSS、环丙沙星或氧氟沙星每30或60分钟给药一次的治疗效果相同（P≥0.2880），每只角膜的CFU减少>5个对数。当单次滴眼时，环丙沙星比环丙沙星-PSS或氧氟沙星活性显著更高（P≤0.0410）。晚期用环丙沙星-PSS、环丙沙星或氧氟沙星每30或60分钟给药一次，与对照组相比，每只角膜的CFU减少>3个对数（P≤0.0001）。
用环丙沙星-PSS、环丙沙星或氧氟沙星局部治疗实验性金黄色葡萄球菌角膜炎是有效的。环丙沙星-PSS的有效性表明，采用离子交换树脂的改进药物输送系统可能对眼部氟喹诺酮制剂有用。
