Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery

Bucci, Frank A.; Evans, Ruth; Amico, L.M.; Morris, Timothy W.; Fluet, Angel T; Sanfilippo, Christine M; DeCory, Heleen H; Comstock, Timothy L.

doi:10.2147/opth.s83162

Cited by 4 publications

(2 citation statements)

References 52 publications

(37 reference statements)

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“…Bucci et al [ 80 ] randomized 67 cataract surgery patients to receive besifloxacin or moxifloxacin before surgery to compare the FQs’ antibacterial efficacy. Patients instilled study drug four times a day for 3 days in the surgical eye and 1 h before surgery in the nonsurgical fellow eye, and bacterial load was assessed at the time of surgery.…”

Section: Resultsmentioning

confidence: 99%

Besifloxacin: Efficacy and Safety in Treatment and Prevention of Ocular Bacterial Infections

Mah

Sanfilippo²

2016

Ophthalmol Ther

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This comprehensive review summarizes the mechanism of action, pharmacokinetics, efficacy, and safety of besifloxacin ophthalmic suspension, 0.6% and examines its role in the treatment of ocular surface bacterial infections. Besifloxacin possesses balanced activity against bacterial topoisomerase II (also called DNA gyrase) and topoisomerase IV. It has shown a low potential to select for bacterial resistance in vitro and demonstrated strong in vitro activity against many Gram-positive, Gram-negative, and anaerobic organisms, including methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis (MRSA and MRSE, respectively). Ocular pharmacokinetic studies have shown that besifloxacin achieves high, sustained concentrations in the tear fluid and conjunctiva following topical administration, with negligible systemic exposure. Large randomized, controlled clinical trials have established the efficacy and safety of besifloxacin administered three times daily for 5 days for treatment of acute bacterial conjunctivitis in both adults and children, with high rates of clinical resolution (up to more than 70% by day 5) and bacterial eradication (more than 90% by day 5), and a low incidence of adverse events. Additionally, besifloxacin applied twice daily for 3 days demonstrated greater efficacy than vehicle in treating bacterial conjunctivitis. Case reports, a large retrospective chart review, and animal studies have provided supporting evidence for the efficacy of besifloxacin in the management of acute bacterial keratitis. There is some evidence to suggest that besifloxacin may provide an advantage over other current-generation fluoroquinolones in antimicrobial prophylaxis for ocular surgery. Besifloxacin is an appropriate option for treatment of bacterial conjunctivitis, and its use in the treatment of bacterial keratitis and lid disorders, as well as for surgical prophylaxis, appears promising and warrants further evaluation.

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Section: Resultsmentioning

confidence: 99%

Besifloxacin: Efficacy and Safety in Treatment and Prevention of Ocular Bacterial Infections

Mah

Sanfilippo²

2016

Ophthalmol Ther

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“…Studies have shown that the minimum inhibitory concentration (MIC) values for besifloxacin against Gram-positive pathogens are consistently lower, by at least two to three dilutions, than those for moxifloxacin and gatifloxacin against the same isolates [3][4][5], Pharmaceuticals 2021, 14, 517 2 of 13 and that besifloxacin was also the most rapidly bactericidal [6]. Besifloxacin ophthalmic suspension 0.6% (Besivance ® , Bausch + Lomb) has been studied clinically for the treatment of bacterial conjunctivitis [7][8][9][10][11][12][13][14] and other potential uses [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Time-Kill of Common Ocular Pathogens with Besifloxacin Alone and in Combination with Benzalkonium Chloride

Blondeau

DeCory²

2021

Pharmaceuticals

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Background: Besifloxacin ophthalmic suspension 0.6% (w/v%) contains benzalkonium chloride (BAK) as a preservative. We evaluated the in vitro time-kill activity of besifloxacin, alone and in combination with BAK, against common bacteria implicated in ophthalmic infections. Methods: The activity of besifloxacin (100 µg/mL), BAK (10, 15, 20, and 100 µg/mL), and combinations of besifloxacin and BAK were evaluated against isolates of Staphylococcus epidermidis (n = 4), Staphylococcus aureus (n = 3), Haemophilus influenzae (n = 2), and Pseudomonas aeruginosa (n = 2) in time-kill experiments of 180 min duration. With the exception of one S. aureus isolate, all of the staphylococcal isolates were methicillin- and/or ciprofloxacin-resistant; one P. aeruginosa isolate was ciprofloxacin-resistant. The reductions in the viable colony counts (log10 CFU/mL) were plotted against time, and the differences among the time–kill curves were evaluated using an analysis of variance. Areas-under-the-killing-curve (AUKCs) were also computed. Results: Besifloxacin alone demonstrated ≥3-log killing of P. aeruginosa (<5 min) and H. influenzae (<120 min), and approached 3-log kills of S. aureus. BAK alone demonstrated concentration-dependent killing of S. epidermidis, S. aureus and H. influenzae, and at 100 µg/mL produced ≥3-log kills in <5 min against these species. The addition of BAK (10, 15, and 20 µg/mL) to besifloxacin increased the rate of killing compared to besifloxacin alone, with earlier 3-log kills of all species except P. aeruginosa and a variable impact on S. aureus. The greatest reductions in AUKC were observed among H. influenzae (8-fold) and S. epidermidis (≥5-fold). Similar results were found when the isolates were evaluated individually by their resistance phenotype. Conclusions: In addition to confirming the activity of 100 µg/mL BAK as a preservative in the bottle, these data suggest that BAK may help besifloxacin to achieve faster time-kills on-eye in the immediate timeframe post-instillation before extensive dilution against bacterial species implicated in ophthalmic infections, including drug-resistant S. epidermidis. Greater killing activity may help prevent resistance development and/or help treat resistant organisms.

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Antibiotic Resistance Among Ocular Pathogens in the United States

Sanfilippo²,

et al. 2015

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IMPORTANCE The Antibiotic Resistance Monitoring in Ocular Microorganisms (ARMOR) study is the only ongoing nationwide antibiotic resistance surveillance program specific to ocular pathogens. OBJECTIVE To report resistance rates and trends among common ocular isolates collected during the first 5 years of the ARMOR study. DESIGN, SETTING, AND PARTICIPANTS This antibiotic resistance surveillance study was performed at an independent central laboratory. Clinical centers across the United States were invited to submit ocular isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Haemophilus influenzae, and

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Antibacterial efficacy of prophylactic besifloxacin 0.6% and moxifloxacin 0.5% in patients undergoing cataract surgery

Cited by 4 publications

References 52 publications

Besifloxacin: Efficacy and Safety in Treatment and Prevention of Ocular Bacterial Infections

Besifloxacin: Efficacy and Safety in Treatment and Prevention of Ocular Bacterial Infections

In Vitro Time-Kill of Common Ocular Pathogens with Besifloxacin Alone and in Combination with Benzalkonium Chloride

Antibiotic Resistance Among Ocular Pathogens in the United States

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