Information de reference pour ce titreAccession Number: | 00008369-200709000-00001.
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Author: | TA, C. N.; SINNAR, S.; HE, L.; MYUNG, D.; DE KASPAR, H. MINO
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Institution: | Department of Ophthalmology, School of Medicine, Stanford University, Stanford, California - USA
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Title: | Prospective randomized comparison of 1-day versus 3-day application of topical levofloxacin in eliminating conjunctival flora.[Article]
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Source: | European Journal of Ophthalmology. 17(5):689-695, September/October 2007.
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Abstract: | Purpose. To compare efficacy of a 1-day versus 3-day application of topical levofloxacin in reducing ocular surface bacteria.
Methods. In this prospective randomized controlled trial, 100 volunteer patients (50 per group) were assigned to receive topical 0.5% levofloxacin four times daily for 1 day or 3 days. Conjunctival cultures were obtained prior to (T0) and after the application of antibiotics (T1). Additionally, all patients received topical levofloxacin at 5-minute intervals for three applications (T2), followed by two drops of topical 5% povidone-iodine (T3). Conjunctival cultures were obtained at timepoints T2 and T3.
Results. A 1-day application of topical levofloxacin significantly reduced (p = 0.0004) the number of eyes with positive conjunctival cultures from 41 eyes (82%) to 23 eyes (46%). Similarly, a 3-day application significantly reduced (p = 0.0001) the positive culture rate from 37 eyes (74%) to 17 eyes (34%). Two drops of povidone-iodine further reduced the positive culture rate for both groups to 20% (10 eyes for each group). There was no significant difference in positive culture rate between the 1-day and 3-day groups at T0 (p = 0.4689), T1 (p = 0.3074), T2 (p = 0.6706), or T3 (p = 1.000).
Conclusions. The application of topical 0.5% levofloxacin for 1 or 3 days significantly reduced the number of eyes with positive conjunctival cultures. The addition of 5% povidone-iodine further eliminated bacteria from the conjunctiva. The application of levofloxacin for 1 day appears to be as effective as a 3-day application. (Eur J Ophthalmol 2007; 17: 689-95)
(C) 2007 Wichtig Editore
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Author Keywords: | Conjunctiva flora; Endophthalmitis; Levofloxacin.
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References: | 1. Bannerman TL, Rhoden DL, McAllister SK, Miller JM, Wilson LA. The source of coagulase-negative staphylococci in the Endophthalmitis Vitrectomy Study. A comparison of eyelid and intraocular isolates using pulsedfield gel electrophoresis. Arch Ophthalmol 1997; 115: 357-61.
2. Speaker MG, Milch FA, Shah MK, Eisner W, Kreiswirth BN. Role of external bacterial flora in the pathogenesis of acute postoperative endophthalmitis. Ophthalmology 1991; 98: 639-49; discussion 650.
3. Liesegang TJ. Use of antimicrobials to prevent postoperative infection in patients with cataracts. Curr Opin Ophthalmol 2001; 12: 68-74.
4. Barry P, Seal DV, Gettinby G, Lees F, Peterson M, Revie CW. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 2006; 32: 407-10.
5. Masket S. Preventing, diagnosing, and treating endophthalmitis. J Cataract Refract Surg 1998; 24: 725-6.
6. De Kaspar HM, Chang RT, Shriver EM, et al. Three-day application of topical ofloxacin reduces the contamination rate of microsurgical knives in cataract surgery: a prospective randomized study. Ophthalmology 2004; 111: 1352-5.
7. Ta CN, Egbert PR, Singh K, Shriver EM, Blumenkranz MS, Mino de Kaspar H. Prospective randomized comparison of 3-day versus 1-hour preoperative ofloxacin prophylaxis for cataract surgery. Ophthalmology 2002; 109: 2036-41.
8. Schmitz S, Dick H, Krummenauer F, Pfeiffer N. Endophthalmitis in cataract surgery: results of a German survey. Ophthalmology 1999; 106: 1869-77.
9. Speaker MG, Menikoff JA. Prophylaxis of endophthalmitis with topical povidone-iodine. Ophthalmology 1991; 98: 1769-75.
10. Isenberg SJ, Apt L, Yoshimori R, Khwarg S. Chemical preparation of the eye in ophthalmic surgery. IV. Comparison of povidone-iodine on the conjunctiva with a prophylactic antibiotic. Arch Ophthalmol 1985; 103: 1340-2.
11. Sherwood D, Rich W, Jacob J, Hart R, Fairchild Y. Bacterial contamination of intraocular and extraocular fluids during extracapsular cataract extraction. Eye 1989; 3: 308-12.
12. Dickey J, Thompson K, Jay W. Anterior chamber aspirate cultures after uncomplicated cataract surgery. Am J Ophthalmol 1991; 112: 278-82.
13. Ariyasu RG, Nakamura T, Trousdale MD, Smith RE. Intraoperative bacterial contamination of the aqueous humor. Ophthalmic Surg 1993; 24: 367-73; discussion 373-4.
14. Ta CN, Egbert PR, Singh K, Blumenkranz MS, de Kaspar HM. The challenge of determining aqueous contamination rate in anterior segment intraocular surgery. Am J Ophthalmol 2004; 137: 662-7.
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Language: | English.
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Document Type: | Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1120-6721
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NLM Journal Code: | bjg, 9110772
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Annotation(s) | |