Systemic Prophylaxis of Experimental Staphylococcal Endophthalmitis: Comparative Efficacy of Sparfloxacin, Peftoxacin, Imipenem, Vancomycin, and Amikacin

Abstract

The preventive efficacy of several antibiotics in experimental staphylococcal endophthalmitis was evaluated. Two hours before bilateral intravitreal infection with 500 cfu of Staphylococcus aureus, 18 pigmented phakic rabbits were assigned to receive a single intramuscular injection of sparfloxacin (50 mg/kg), pefloxacin (50 mg/kg), imipenem (50 mg/kg), vancomycin (30 mg/kg), amikacin (15 mg/kg), or saline and were killed 24 h after infection (6 eyes/group). Sparfloxacin, pefloxacin, and imipenem were significantly (P < .001) more effective than saline. All but 1 of the sparfloxacin-treated eyes were culture negative. To determine whether the effect persisted, an additional 24 rabbits were treated with sparfloxacin, pefloxacin, imipenem, or saline and were killed 48 h after infection (12 eyes/group). Sparfloxacin, pefloxacin, and imipenem were effective (P < .001). All sparfloxacin-treated eyes remained culture negative. These results show that systemic antibiotic administration prevents the development of experimental endophthalmitis and that further studies of sparfloxacin as a prophylactic agent are warranted.

The Efficacy of Intravitreal Levofloxacin and Intravitreal Dexamethasone in Experimental <i>Staphylococcus epidermidis</i> Endophthalmitis

“…However, experimental data suggest that intravitreal corticosteroids may be beneficial. Quinolone antimicrobials have been increasingly studied in endophthalmitis [12][13][14][15][16]. The quinolones as a group remain potentially beneficial because they provide the advantage of a broad spectrum, excellent penetration into biologic fluids including the aqueous and vitreous humor, and rapid bactericidal action [28].…”

“…In previous studies, quinolone antimicrobials have been tried for both the prophylactic [12] and curative [15,16] treatment of infectious endophthalmitis. MarrakchiBenjaafar et al [12] used various antibiotics in the systemic prophylaxis of experimental staphylococcal endophthalmitis and reported that the systemic administration of sparfloxacin can prevent the development of experimental endophthalmitis.…”

“…MarrakchiBenjaafar et al [12] used various antibiotics in the systemic prophylaxis of experimental staphylococcal endophthalmitis and reported that the systemic administration of sparfloxacin can prevent the development of experimental endophthalmitis. Ng et al [15] stated that the administration of oral trovafloxacin alone for the treatment of endophthalmitis may not be suitable and that the agent may be useful adjunctively.…”

“…Quinolone antibiotics have been increasingly used in the treatment of infectious endophthalmitis [12][13][14][15][16]. Levofloxacin is a novel fluoroquinolone effective against gram-positive organisms compared with currently available antimicrobial agents in this class including ciprofloxacin and ofloxacin.…”

Intravitreal Trovafloxacin against Experimental <i>Staphylococcus epidermidis</i> Endophthalmitis

“…Staphylococcus epidermidis is the most common cause of postoperative endophthalmitis [1,2]. Systemic, topical, subconjunctival and intravitreal forms of administration of various antibiotics, including cefazolin [3], vancomycin [4,5] and quinolones [6,7], have been tried for the treatment of bacterial endophthalmitis caused by S. epidermidis with limited success. Trovafloxacin is a novel fluoroquinolone effective against gram-positive organisms compared with currently available antimicrobial agents of this class including ciprofloxacin and ofloxacin [8].…”