Fourth generation fluoroquinolones: new weapons in the arsenal of ophthalmic antibiotics
Abstract
PURPOSE: Fourth generation fluoroquinolones (FQs) will soon be introduced to ophthalmology. In this in vitro study, differences in the susceptibility patterns and the potencies of fourth generation FQs (gatifloxacin-GAT and moxifloxacin-MOX) were compared with third generation (levofloxacin-LEV) and second generation FQs (ciprofloxacin-CIP and ofloxacin-OFX).
DESIGN: Experimental laboratory investigation.
METHODS: In retrospect, the minimum inhibitory concentrations (MICs) of 93 bacterial endophthalmitis isolates were determined to CIP, OFX, LEV, GAT, and MOX using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS) susceptibility patterns and the potencies of the MICs were statistically compared.
RESULTS: With in vitro tests, Staphylococcus aureus isolates that were resistant to CIP and OFX were statistically most susceptible (P =.01) to MOX. Coagulase negative Staphylococci that were resistant to CIP and OFX were statistically most susceptible (P =.02) to MOX and GAT. Streptococcus viridans were more susceptible (P =.02) to MOX, GAT, and LEV than CIP and OFX. Streptococcus pneumoniae was least susceptible (P =.01) to OFX compared with the other FQs. Susceptibilities were equivalent (P =.11) for all other bacterial groups. In general, MOX was the most potent FQ for gram-positive bacteria (P =.05) while CIP, MOX, GAT, and LEV demonstrated equivalent potencies to gram-negative bacteria.
CONCLUSIONS: This in vitro study indicated that fourth generation FQs…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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