J.ophthalmol.(Ukraine).2017;2:44-50.

https://doi.org/10.31288/oftalmolzh201724450

Current antibacterial therapy for ocular burns

S.A. Iakymenko, Dr. Sc. (Med), Prof.

E.A. Khrustaliova

O.I. Buznyk, Cand. Sc. (Med), MD

P.O. Kostenko, Cand. Sc. (Med)

A.L. Molodaia, L.V. Dolenko

Filatov Institute of Eye Diseases and Tissue Therapy

Odessa, Ukraine

 

Background: Since ocular infection is common following ocular burns, and may lead to severe infectious complications like corneal ulcers, infiltrates and abscesses, prevention and treatment of these complications has been always important.

Purpose: To investigate the nature of the microflora cultured from ocular burn patients and the sensitivity of this microflora to current antibacterial agents.

Materials and Methods: We investigated conjunctival microflora from 184 ocular burn patients (224 eyes) at different time points following ocular burns. In total, 559 cultures were performed. Antibacterial and antiseptic agents under investigation included ciprofloxacin (Floximed), ofloxacin, levofloxacin (Levofloximed), moxifloxacin, gentamycin, tobramycin (Tobrimed), futaron, octenisept and betadine.

Results: Microflora was cultured from 88% of the conjunctival samples examined. Staphylococcus epidermidis was the most commonly cultured organism (54.2%), followed by Staphylococcus aureus (14.3%), Escherichia coli (7.6%), Enterococci (5.6%), fungi (3.0%), Staphylococcus haemolyticus (2.5%), Pseudomonas aeruginosa (1.5%), and Streptococcus haemolyticus (0.4%). No organisms were isolated from 12% of the conjunctival microflora samples. The sensitivity of these microorganisms to each of the antibacterial agents under investigation was determined. Levofloxacin (Levofloximed), ciprofloxacin (Floximed), moxifloxacin, ofloxacin, gentamycin, and tobramycin (Tobrimed) demonstrated high antibacterial activity against the organisms.

Conclusion: Following ocular burns, conjunctival microflora always contains organisms that can cause various infectious complications. Administration of antibacterial medications for prevention and treatment of infectious complications should be based on the sensitivity of the organisms to these medications. Prior to obtaining the results of sensitivity analyses of cultured microorganisms, or if such tests are unavailable, broad spectrum antibiotics, ? fluoroquinolones (moxifloxacin, levofloxacin (Levofloximed), and ciprofloxacin (Floximed)) and aminoglycosides (gentamycin and tobramycin (Tobrimed)) ? should be administered.

If the microorganism exhibits no sensitivity to antibiotics, such antiseptics as octenisept or betadine may be administered.

Key words: ocular burns, microflora, antibacterial therapy

References

1.   Puchkovskaya NA, Iakymenko SA, Nepomiaschaia VM. [Ocular burns]. Moscow: Meditsina; 2001 Russian

2.   Iakymenko SA, Khrustaliova EA, Molodaia AL. [Features of conjunctival mircroflora of ocular burn patients and its sensitivity to antibacterial agents]. Oftalmol Zh. 2008; 1:37-41 Russian

3.   Egorov EA, Astakhov IuS, Stavitskaya TV. [Ocular pharmacology]. Moscow: GEOTAR-Media; 2002 Russian

4.   Egorov EA, Alekseev VN, Astakhov IuS. [Rational pharmacotherapy in ophthalmology: A guide for practitioners]. 2nd Edition. Moscow: Literra; 2011 Russian

5.   Davis R, Bryson HM. Levofloxacin: A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1994;47:471-505
Crossref   Pubmed

6.   Klimniuk SL, Sytnyk IO, Tvorko MS, Shyrobokov VP. [Practical microbiology]. Ternopil: Ukrmedknyga, 2004 Ukrainian

7.   Pozdeiev OK, Pokrovskii VI. [Medical microbiology]. Moscow: GEOTAR-Meditsina; 1999 Russian

8.   Donnenfeld ED. Penetration of topically applied ciprofloxacin, norfloxacin, and ofloxacin into the aqueous humor. Ophthalmology. 1994 May;101(5):902-5
Crossref   Pubmed