In vitro susceptibility of bacterial keratitis pathogens to ciprofloxacin. Emerging resistance

Ophthalmology. 1999 Jan;106(1):80-5. doi: 10.1016/S0161-6420(99)90008-8.

Abstract

Objective: To examine in vitro susceptibility of bacterial keratitis pathogens to ciprofloxacin.

Design: Retrospective review.

Participants: The authors examined in vitro susceptibility of 1558 corneal isolates from 1303 patients with culture-proven bacterial keratitis seen at the LV Prasad Eye Institute in Hyderabad, India, during the 6-year period between March 1, 1991, and June 30, 1997.

Results: Of 1558 corneal isolates, 478 (30.7%) were not sensitive to ciprofloxacin. Among the isolates, 355 (32.5%) of the 1091 gram-positive cocci were not sensitive to ciprofloxacin, and 2 (10%) of the 20 gram-positive bacilli, 22 (13.3%) of the 165 gram-negative organisms, and 99 (35.1%) of the 282 Actinomycetes and related organisms were not sensitive to ciprofloxacin. Results from chi-square for trends analysis showed a trend of significantly increasing ciprofloxacin insensitivity in bacteria between 1992 and 1997 (P = 0.011).

Conclusion: This is the first report of significantly increasing ciprofloxacin insensitivity among corneal pathogens. Although the lowered cost and convenience of dispensing a single, commercially available antibiotic such as ciprofloxacin in the initial treatment of bacterial keratitis is desirable, the emergence of ciprofloxacin resistance is a significant finding in this series, and the clinician should proceed with caution in the initial empiric treatment of bacterial keratitis with ciprofloxacin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents / pharmacology*
  • Bacteria / drug effects*
  • Bacteria / isolation & purification
  • Ciprofloxacin / pharmacology*
  • Colony Count, Microbial
  • Corneal Ulcer / drug therapy
  • Corneal Ulcer / microbiology*
  • Drug Resistance, Microbial
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Eye Infections, Fungal / drug therapy
  • Eye Infections, Fungal / microbiology*
  • Fungi / drug effects*
  • Fungi / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Retrospective Studies

Substances

  • Anti-Infective Agents
  • Ciprofloxacin