OBJECTIVE: To analyze the relationship between fluoroquinolone use at presentation and minimum inhibitory concentration in bacterial keratitis. METHODS: The Steroids for Corneal Ulcers Trial was a randomized, double-masked, placebo-controlled trial assessing the effect of adjunctive topical corticosteroid treatment on outcomes in bacterial keratitis. After presentation, all patients were treated with moxifloxacin hydrochloride, 0.5%. We compare antibiotic use at presentation with minimum inhibitory concentration against moxifloxacin for all isolates. Separate analyses accounted for organism species and fluoroquinolone generation. RESULTS:Topical fluoroquinolone use at presentation was reported in 92 of 480 cases (19.2%). Causative organisms in the 480 cases included Streptococcus pneumoniae (247 cases [51.5%]), Pseudomonas aeruginosa (109 cases [22.7%]), and Nocardia species (55 cases [11.5%]). Isolates from patients who reported fluoroquinolone use at presentation had a 2.01-fold-higher minimum inhibitory concentration (95% CI, 1.39-fold to 2.91-fold; P < .001). Fourth-generation fluoroquinolones were associated with a 3.48-fold-higher minimum inhibitory concentration than those isolates that were not exposed to pretreatment at enrollment (95% CI, 1.99-fold to 6.06-fold; P < .001). CONCLUSION: This study provides evidence that prior use of fluoroquinolones is associated with antibiotic resistance. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00324168.
RCT Entities:
OBJECTIVE: To analyze the relationship between fluoroquinolone use at presentation and minimum inhibitory concentration in bacterial keratitis. METHODS: The Steroids for Corneal Ulcers Trial was a randomized, double-masked, placebo-controlled trial assessing the effect of adjunctive topical corticosteroid treatment on outcomes in bacterial keratitis. After presentation, all patients were treated with moxifloxacin hydrochloride, 0.5%. We compare antibiotic use at presentation with minimum inhibitory concentration against moxifloxacin for all isolates. Separate analyses accounted for organism species and fluoroquinolone generation. RESULTS: Topical fluoroquinolone use at presentation was reported in 92 of 480 cases (19.2%). Causative organisms in the 480 cases included Streptococcus pneumoniae (247 cases [51.5%]), Pseudomonas aeruginosa (109 cases [22.7%]), and Nocardia species (55 cases [11.5%]). Isolates from patients who reported fluoroquinolone use at presentation had a 2.01-fold-higher minimum inhibitory concentration (95% CI, 1.39-fold to 2.91-fold; P < .001). Fourth-generation fluoroquinolones were associated with a 3.48-fold-higher minimum inhibitory concentration than those isolates that were not exposed to pretreatment at enrollment (95% CI, 1.99-fold to 6.06-fold; P < .001). CONCLUSION: This study provides evidence that prior use of fluoroquinolones is associated with antibiotic resistance. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00324168.
Authors: Prajna Lalitha; Muthiah Srinivasan; P Manikandan; M Jayahar Bharathi; Revathi Rajaraman; Meenakshi Ravindran; Vicky Cevallos; Catherine E Oldenburg; Kathryn J Ray; Christine M Toutain-Kidd; David V Glidden; Michael E Zegans; Stephen D McLeod; Nisha R Acharya; Thomas M Lietman Journal: Clin Infect Dis Date: 2012-03-23 Impact factor: 9.079
Authors: Muthiah Srinivasan; Jeena Mascarenhas; Revathi Rajaraman; Meenakshi Ravindran; Prajna Lalitha; David V Glidden; Kathryn J Ray; Kevin C Hong; Catherine E Oldenburg; Salena M Lee; Michael E Zegans; Stephen D McLeod; Thomas M Lietman; Nisha R Acharya Journal: Arch Ophthalmol Date: 2011-10-10
Authors: Herminia Miño de Kaspar; Michael J Koss; Lingmin He; Mark S Blumenkranz; Christopher N Ta Journal: Am J Ophthalmol Date: 2005-04 Impact factor: 5.258
Authors: Lawson Ung; Paulo J M Bispo; Swapna S Shanbhag; Michael S Gilmore; James Chodosh Journal: Surv Ophthalmol Date: 2018-12-24 Impact factor: 6.048
Authors: Kathryn J Ray; Prajna Lalitha; N Venkatesh Prajna; Revathi Rajaraman; Tiruvengada Krishnan; Muthiah Srinivasan; Peter Ryg; Stephen McLeod; Nisha R Acharya; Thomas M Lietman; Jennifer Rose-Nussbaumer Journal: Am J Ophthalmol Date: 2017-04-04 Impact factor: 5.258
Authors: Darren Shu Jeng Ting; Charlotte Shan Ho; Rashmi Deshmukh; Dalia G Said; Harminder S Dua Journal: Eye (Lond) Date: 2021-01-07 Impact factor: 3.775