Ofloxacin Group Research Articles

Achilles tendon complications of fluoroquinolone treatment: a molecule-stratified systematic review and meta-analysis.

The association between fluoroquinolone intake and Achilles tendinopathy (AT) or Achilles tendon rupture (ATR) is widely documented. However, it is not clear whether different molecules have the same effect on these complications. The purpose of this study was to document Achilles tendon complications for the most prescribed fluoroquinolones molecules. A literature search was performed on Pubmed, Cochrane, Embase, and Web of Science databases up to April 2023. Inclusion criteria: studies of any level of evidence, written in English, documenting the prevalence of AT/ATR after fluoroquinolone consumption and stratifying the results for each type of molecule. The Downs and Black's 'Checklist for Measuring Quality' was used to evaluate the risk of bias. Twelve studies investigating 439,299 patients were included (59.7% women, 40.3% men, mean age: 53.0 ± 15.6 years). The expected risk of AT/ATR was 0.17% (95% CI: 0.15-0.19, standard error (s.e.): 0.24) for levofloxacin, 0.17% (95% CI: 0.16-0.19, s.e.: 0.20) for ciprofloxacin, 1.40% (95% CI: 0.88-2.03, s.e.: 2.51) for ofloxacin, and 0.31% (95% CI: 0.23-0.40, s.e.: 0.77) for the other molecules. The comparison between groups documented a significantly higher AT/ATR rate in the ofloxacin group (P < 0.0001 for each comparison). Levofloxacin and ciprofloxacin showed the same risk (P = n.s.). The included studies showed an overall good quality. Ofloxacin demonstrated a significantly higher rate of AT/ATR complications in the adult population, while levofloxacin and ciprofloxacin showed a safer profile compared to all the other molecules. More data are needed to identify other patient and treatment-related factors influencing the risk of musculoskeletal complications.

The Effect of Using Ofloxacin Ear Drops in Traumatic Tympanic Membrane Healing: A Systematic Review and Meta-Analysis.

Objectives: To evaluate the effectiveness of ofloxacin ear drops versus no intervention in the repair of traumatic tympanic membrane (TM) perforations from randomized controlled trials (RCTs). Data Sources: Medline/PubMed, CENTRAL, Clinical Trials.Gov, and Google Scholar. Study Selection: Inclusion criteria: (1) English language; (2) RCT studies; (3) reported the outcomes on the application of ofloxacin and outcomes of spontaneous healing. Exclusion criteria: (1) studies without a control group; (2) patient with severe otologic disease such as chronic suppurative otitis media or ossicular disruption or patients with craniocerebral injury; (3) studies with no pretreatment values or single-arm clinical studies. Data Extraction: Country, year of publication, number of participants in each arm, patient characteristics such as age, sex, intervention details, laterality, cause of TM perforation, position of perforation, follow-up time, hearing gain, rate of TM closure, and closure time. Results: A total of 6 RCTs studies were analyzed. A total of 502 participants were included; the relative risk for closure rate of ofloxacin treatment was 1.18 [95% confidence interval (CI), 1.08 to 1.28, P < .001] and the mean difference (MD) for healing time was -18.4 (95% CI, -19.96 to -16.82, P < .001), suggesting ofloxacin has a significant effect on closure of TM perforations. However, no clinically significant effect in hearing (SMD: 0.21, 95% CI, 0.02 to 0.40, P = .03) was seen in ofloxacin group. Also, patients in the ofloxacin group were associated with a 13% reduction in the risk of infections compared to their observation-assigned counterparts, but this estimate was not statistically significant. Conclusion: Ofloxacin use in patients with traumatic TM perforation is effective in reducing healing time and increasing rate of TM perforation closure. No evidence of increased risk of hearing loss or infection rates are encountered when ofloxacin is prescribed to patients with traumatic TM perforation.

Evaluation of Pharmacological Activities of Piper Betle L. Extract on Bacterial Conjunctivitis Model of Wistar Rat caused by Streptococcus Pneumoniae

Abstract&#x0D; Introduction &amp; Objectives : Conjunctivitis is an eye infection accounted as the third leading ophthalmology cases after cataract and glaucoma globally, with Streptococcus pneumoniae as the main causes in children. Several studies had indicated that Piper betle L. extract inhibited Streptococcus pneumoniae growth. To determine and evaluation of pharmacological activities of Piper Betle L. extract on bacterial conjunctivitis model of wistar rat caused by Streptococcus Pneumoniae&#x0D; Methods : This study was an analytical study with true experimental design and pre-test-post-test control group. Streptococcus pneumoniae colony growth media was analyzed using Mueller Hinton agar. Streptococcus pneumoniae colony was calculated using Total Plate Count methods.&#x0D; Results : Sample of this study involved 30 male wistar rat aged 4 – 9 minggu. Kruskal Wallis test reveald a significant differences of Streptococcus pneumoniae colony based on the treatment group (p=0,023). Subsequent test using Posthoc revealed that there was a significant differences in Streptococcus pneumoniae colony between placebo group and group using 25% (p = 0,039) and 30% (p=0,006) piper betle. Test results also revealed that no significant difference was found between placebo group and groups using 20% piper betle (p=0,159) and ofloxacin (p=1,000).&#x0D; Conclusion : There was a significant difference in Streptococcus pneumoniae colony among placebo group and piper betle eyedrops 25 % and 30 % group. However, significant result among placebo group and piper betle L. 20 % and ofloxacin group were absent.

EVALUATION OF PHARMACOLOGICAL ACTIVITIES OF PIPER BETLE L. EXTRACT ON BACTERIAL CONJUNCTIVITIS MODEL OF WISTAR RAT CAUSED BY STREPTOCOCCUS PNEUMONIAE

Introduction: Conjunctivitis is an eye infection accounted as the third leading ophthalmology cases after cataract and glaucoma globally, with Streptococcus pneumoniae as the main causes in children. Several studies had indicated that Piper betle L. extract inhibited Streptococcus pneumoniae growth. Methods: This study was an analytical study with true experimental design and pre-test-post-test control group. Streptococcus pneumoniae colony growth media was analyzed using Mueller Hinton agar. Streptococcus pneumoniae colony was calculated using Total Plate Count methods. Results: Sample of this study involved 30 male wistar rat aged 4 – 9 minggu. Kruskal Wallis test reveald a significant differences of Streptococcus pneumoniae colony based on the treatment group (p=0,023). Subsequent test using Posthoc revealed that there was a significant differences in Streptococcus pneumoniae colony between placebo group and group using 25% (p = 0,039) and 30% (p=0,006) piper betle. Test results also revealed that no significant difference was found between placebo group and groups using 20% piper betle (p=0,159) and ofloxacin (p=1,000). Conclusion: There was a significant difference in Streptococcus pneumoniae colony among placebo group and piper betle eyedrops 25 % and 30 % group. However, significant result among placebo group and piper betle L. 20 % and ofloxacin group were absent. Keywords: Bacterial conjungtivitis, Streptococcus pneumoniae, Piper betle L.

Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins.

Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins.

Efficacy of Human Epidermal Growth Factor in the Regeneration of Tympanic Membrane Perforation

Introduction: Majority of tympanic membrane perforations require myringoplasty for closure. Recently, epidermal growth factor (EGF) has been shown to promote the healing of tympanic membrane perforations. Aim: The aim of this study was to find out a simple nonsurgical outpatient procedure to close one-quadrant tympanic membrane perforations that could reduce the hospital stay, medical cost, and morbidity in these patients. Materials and Methods: An interventional prospective randomized clinical study was done on 120 patients at our tertiary hospital. The allocation ratio was 3:1. Pure-tone audiometry, otomicroscopy, and otoenodoscopic recording were performed in all eligible patients who consented to take part in the study. Ninety cases received EGF gel application, whereas 30 controls received antibiotic ofloxacin application. Trichloroacetic acid chemical cautery and fibrin glue application were done in patients of both groups. Results: The closure rate was 97.7% in the EGF group and 70% in the ofloxacin group. The time taken for closure of perforations was 10 to 14 days in the EGF group and 3–4 weeks in the ofloxacin group. Hearing gain was observed in healed perforations of both groups. Conclusion: EGF application enhances the healing effect of one-quadrant nonhealing tympanic membrane perforations. It showed encouraging results and reliable safety in the regeneration of tympanic membrane. Clinical Significance: Apart from its use in single quadrant perforation, EGF may be considered for treating residual perforations after failed tympanoplasty.

The effect of topical ophthalmic proparacaine, fluorescein, and tropicamide on subsequent bacterial cultures in healthy dogs.

To determine whether tropicamide, fluorescein, and proparacaine applied topically before sample collection affect the quantity or species of bacteria isolated via aerobic culture. 12 female adult research beagle cross-breed dogs. A conjunctival swab was taken before and after the sequential application of proparacaine, tropicamide, and fluorescein to the same eye (P/T/F) with a five-minute gap between medications. Paired swabs were submitted for aerobic culture. Bacterial enumeration was performed using the spread plate method. Following a one-week washout period, the procedure was repeated using balanced salt solution (BSS). Following a second one-week washout period, the experiment was repeated using ofloxacin 0.3% solution. Colony counts were compared using one-way ANOVA and Tukey post hoc comparison. Bacterial species reduction was compared using a Friedman rank test and Dunn's method. The bacterial colony count for P/T/F and BSS was significantly higher than the ofloxacin group (p=0.0052, p=0.0022). There was no significant difference for colony counts between P/T/F and BSS (p=0.9295). The most frequently isolated bacteria included: Psychrobacter spp., Staphylococcus spp., Corynebacterium spp., and Streptococcus spp. The bacterial species reduction for P/T/F and BSS was significantly lower than for ofloxacin (p<0.0001, p=0.0160). There was no significant difference for species reduction between P/T/F and BSS (p=0.3749). The application of proparacaine, tropicamide, and fluorescein did not significantly decrease the amount or species of bacteria isolated from the conjunctiva in this canine population. The application of these solutions prior to ocular swab collection in healthy dogs is unlikely to affect subsequent culture results.

Identification and Antimicrobial Susceptibility of Granulicatella adiacens Isolated from Periodontal Pocket

Background: Periodontal diseases often occur in developing and developed countries, affecting 20 – 50% of the world population. Periodontitis may also complicate systemic health and have a risk to cause endocarditis infection. Granulicatella adiacens, part ofnutritionally variant streptococci (NVS), was proven to cause many diseases, especially endocarditis infection. GA was a part of commensal bacteria but also found to be causing periodontitis by co-aggregating with Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The frequent used of antibiotics nowadays has led to increased resistance, and this concern led us to examine susceptibilities among several antibiotics. This study was conducted to prove which antibiotic can eliminate Granulicatella adiacens for its potential risk. Methods and Material: Bacteriasamples were isolated from 28 patients with periodontitis. The samples were delivered to the microbiology laboratory to be cultured and purified. After purification, the samples were identified using GP VITEK 2 Compact and tested using the antibiotic disc to find out the susceptibility rates. Results: From 28 samples, 20 samples were identified containing Granulicatella adiacens. Those samples were tested on seven types of antibiotic which is ofloxacin, ceftriaxone, azithromycin, vancomycin, tetracycline, levofloxacin, and clindamycin. Sensitive isolates were found on 90% of ofloxacin and levofloxacin group, 85% of azithromycin group, 50% of vancomycin group, and less than 50% for three other groups. High resistance percentages were found on cefriaxone (55%), vancomycin (45%), clindamycin (40%), tetracycline (30%), and less than 15% for three other groups. Conclusion: Ofloxacin and levofloxacin were found to be the most sensitive antibiotic tested, while ceftriaxone was the worst antibiotic in eliminating Granulicatella adiacens.

Biliary antibiotics irrigation for E. coli-induced chronic proliferative cholangitis and hepatolithiasis: A pathophysiological study in rabbits

The gram-negative bacteria secreted endotoxin, Lipopolysaccharide (LPS), plays important roles in the formation and recurrence of hepatolithiasis and chronic biliary inflammation in patients of Southeast Asia. We aimed to elucidate the anti-inflammatory effect and mechanism of local antibiotics irrigation on chronic proliferative cholangitis (CPC) and hepatolithiasis. Escherichia coli was injected into rabbit bile ducts to induce CPC. Rabbits were divided into sham operation (SO), povidone-iodine, Metronidazole plus chlorhexidine, ofloxacin, furacillin, Neosporin® G.U., and CPC groups. Local irrigation was performed for 28 days after CPC was established. Residual E.coli and LPS, and the expression of MCP-1, CD14, COX-2, VEGF, IL-6, NF-κB, TNF-α, Fas, TGF-β1, α-SMA, Collagen-I, β-glucuronidase, PKC, C-myc, and Mucin 5AC were assessed in bile duct tissues. The residual E.coli and LPS, and expression of MCP-1, CD14, COX-2, IL-6, NF-κB, TNF-α, Fas, TGF-β1, α-SMA, β-glucuronidase, PKC, C-myc, and Mucin 5AC in the SO, povidone-iodine, Metronidazole plus chlorhexidine, ofloxacin, and Neosporin® G.U. groups were significantly lower than those in the furacillin and CPC groups (P<0.05). VEGF and Collagen-I levels in the SO, povidone-iodine, metronidazole plus chlorhexidine, and ofloxacin groups were significantly lower than those in the furacillin, Neosporin® G.U., and CPC groups (P<0.05). LPS affects the pathophysiology of E.coli caused chronic proliferative cholangitis and hepatolithiasis recurrence. Local antibiotics irrigation could prevent chronic proliferative cholangitis and stones formation by decreasing LPS-induced proinflammatory and profibrotic cytokines release. Povidone iodine, metronidazole plus chlorhexidine, and ofloxacin were more effective than Neosporin® G.U. and furacillin.

Protective effect of royal jelly on the DNA integrity of sperms and early in vitro embryonic development in ofloxacin treated rats

Protective effects of royal jelly on ofloxacin in male rat reproductive system are not well-known. This study was designed to determine the protective effects of royal jelly on the DNA integrity of sperms and early in vitro embryonic development in ofloxacin treated rats. In this study, 32 adult male rats were used and randomly allocated into 4 groups, each consisted of eight rats and dosed daily for 28 days by oral gavage: control—distilled water (216 mg/kg BW); ofloxacin group—ofloxacin (216 mg/kg BW); royal jelly group—royal jelly (100 mg/kg BW); royal jelly with ofloxacin group—216 mg/kg BW ofloxacin and 100 mg/kg BW royal jelly. The results showed that sperm viability, sperm population, sperm maturation, DNA maturity, hatching, IVF, GSH, and blastocyst significantly decreased (P < 0.05) in the ofloxacin group compared to the control. However, ofloxacin only caused significant increases (P < 0.05) in testis weight, immature sperm, and DNA damage of sperm compared to control group. In the ofloxacin with royal jelly group, there were not any important alterations detected and all sperm parameter returned to normal range. Royal jelly has protective effects on the DNA maturity of sperms and early in vitro embryonic development in ofloxacin treated rats.

Dornase Alfa Ototoxic Effects in Animals and Efficacy in the Treatment of Clogged Tympanostomy Tubes in Children

Many treatments for clogged tympanostomy tubes (TTs) have been proposed, but none have met scientific rigor for safety and efficacy, including the popular empirical use of ototopical antibiotic drops. Dornase alfa, a recombinant molecule with the unique property of cleaving DNA, may be ideal in treating clogged TTs because both middle-ear effusion and the plug are abundant with DNA. To investigate the ototoxic effects of dornase alfa in a chinchilla model and its efficacy in a clinical trial in children with clogged TTs. The safety profiles of dornase alfa (full-strength and 1:10 strength) were evaluated in chinchilla middle ears using serial auditory brainstem response. The efficacy of ototopical dornase alfa (full-strength) was evaluated in children with clogged TTs in a prospective, single-blind randomized clinical trial. The animal study included 21 chinchillas and was conducted at Loma Linda University, Loma Linda, California, and the clinical trial was conducted at Children's Hospital Colorado, Aurora. A total of 40 children (50 ears with tubes) were enrolled. In the animal study, chinchillas were assigned to 3 groups: controls (saline), full-strength dornase alfa, or 1:10 dornase alfa dilution. Children were randomly assigned to receive either topical dornase alfa or ofloxacin for clogged TT, 5 drops each ear twice a day for 7 days. Animal study: Auditory brainstem responses. Randomized trial of children participants: The primary outcome was patency of TT at day 14 assessed by otoscopy and tympanometry. The chinchilla study showed similar auditory brainstem response degradation during a 6-hour period between the control (n = 5) and treatment groups (n = 21). In the clinical trial, a total of 40 clogged TTs (in 33 children, including 25 boys [76%]; mean age, 4.3 years; median [range] age, 3.4 [1.0-14.3] years) were analyzed. The number of unclogged TTs was higher in the dornase alfa group (13 [59%]) compared with the ofloxacin group (8 [44%]), with a difference of 15% (odds ratio, 1.8; 95% CI, 0.54-6.72). The chinchilla model suggests that dornase alfa is likely nonototoxic. The pilot clinical trial failed to show efficacy of dornase alfa to unclog TTs. With the difference seen between the treatment groups, a sample size estimate could be calculated for a future large-scale trial. ClinicalTrials.gov identifier: NCT00419380.

Monitoring, evaluation and comparison of adverse effect profile of ciprofloxacin and ofloxacin in acute bacterial exacerbation of chronic bronchitis patients attending pulmonology department of tertiary care teaching hospital: a prospective observational study

Background: In 2016, FDA recommended that “serious side effects associated with flouroquinolones generally outweigh the benefits for the patients with acute sinusitis, acute bronchitis and uncomplicated UTI”. Throughout India the most commonly used flouroquinolones for above conditions are Ciprofloxacin, Ofloxacin, and Levofloxacin. In this scenario, the present study was undertaken to monitor, evaluate and compare the adverse effect profile of Ciprofloxacin and Ofloxacin in acute exacerbation of chronic bronchitis patients.Methods: Prospective, observational study done in 200 patients of tertiary care teaching hospital. The patients diagnosed with, acute bronchitis treated with Ciprofloxacin 500mg BD or Ofloxacin 400mg BD for 7 days were included in the study. The study duration was 6 months. ADR causality assessment was done with Naranjo algorithm. Statistical test applied was chi- square test.Results: 63 ADR were reported in Ofloxacin group and 19 ADR in Ciprofloxacin group. Insomnia was most frequent ADR (40%) in patients treated with Ofloxacin. There is high incidence of ADRs in ofloxacin group. chi square test showed this difference is statistically significant (p&lt;0.05). Insomnia was significantly higher in ofloxacin group (p&lt;0.05).Conclusions: In India frequently used and misused antimicrobials are fluoroquinolones. The present study concluded that no serious ADRs but ofloxacin group of patients have shown increased incidence of ADRs associated with CNS especially Insomnia. However, further large scale, multi-centric studies are needed to confirm these results.

Treatment of acute bacterial conjunctivitis with topical lomefloxacin 0.3% compared to topical ofloxacin 0.3.

The main purpose of this prospective study was to compare the efficacy, local tolerance, and safety of topical lomefloxacin 0.3% and topical ofloxacin 0.3% in the treatment of acute bacterial conjunctivitis. PATIENS AND METHODS. Forty patients with acute bacterial conjunctivitis were included in a randomized, prospective, parallel-group study. Twenty patients were assigned to the lomefloxacin group (Okacin, CIBA Vision Ophthalmics) and 20 patients to ofloxacin (Oflox, Allergan). Lomefloxacin 0.3% was given 1 drop every 2 hours during waking hours on the first day then twice daily for one week. Ofloxacin 0.3% eyedrops were given four times daily. All patients underwent eye examination and clinical findings were graded and recorded according to severity of lid hyperemia, lid edema, lid crusting, conjunctival edema and discharge, bulbar conjunctival hyperemia, palpebral conjunctival hyperemia, corneal edema, and ocular discomfort. The score for each clinical sign was recorded before and after treatment. The mean cumulative sum score (CSS) was obtained by adding the scores for signs and symptoms. All conjunctival swabs were cultured and tested for sensitivity. Patients with confirmed bacterial conjunctivitis were included. There were 10 male and 10 female patients in each group. The age range was from 1 to 78 years, and the mean age was 35 years in the lomefloxacin group. In the ofloxacin group the age range was from 1 to 70 years, and the mean age was 26 years. There was no significant difference between the two groups in relation to age or sex. The causative organisms were Staphylococcus epidermidis in 16 cases (36%), a-hemolytic Streptococci in 9 (20%), Haemophilus spp. 6 (13%), Staphylococcus aureus 5 (11%), Streptococcus pneumoniae 4 (9%), Pseudomonas aeruginosa 3 (7%), and other 2 (4%). The mean CSS for conjunctivitis was 12.1 before therapy in the lomefloxacin group and 12.7 in the ofloxacin group. On the 7th day of therapy, the mean CSS was 0.7 in the lomefloxacin group, and 1.6 for ofloxacin. All patients showed improvement, but a total of 18 out of 20 (88%) in the lomefloxacin group showed complete resolution compared to 15 (75%) in the ofloxacin group. The difference was not statistically significant (p = 0.08). Tolerance was excellent in both groups, and no side effects were reported. A burning sensation was noted by two patients, one in each group. Lomefloxacin and ofloxacin were equally effective and safe in the treatment of acute bacterial conjunctivitis. (Eur J Ophthalmol 1999; 9: 269-75).

A Comparative Study of the Combination of Drugs - Amoxicillin with Metronidazole and Ofloxacin with Ornidazole In the Treatment of Dentoalveolar Abscess

To compare the efficacy of combination of capsule. amoxicillin 500 mg with tablet. metronidazole 400 mg at 8 hrly interval with fixed dose combination of tablet. Ofloxacin (200 mg) + ornidazole (500 mg) at 12 hrly interval for 5 days in the treatment of dentoalveolar abscess. Materials and method: This comparative study included sample size of 160 patients recorded within 6 months and diagnosed clinically with dentoalveolar abscess visiting dental unit of Saveetha Medical college: in order to match the estimated sample size a few patients from Mohit private dental clinic, Valasaravakam were included. A standardized method for data collection and oral examination was followed. The patients were recruited to anyone of the two groups to which the investigator was blind. The treatment allotment code was kept confidentially with the treating dentist and only at the end of the study the code was broken and revealed to the investigator. The patients were advised to come for check up on the third day. In case if any problem arised before the advised visit, due to the condition or the therapy, the patients were informed to contact the treating dentist. Assessment of clinical improvement in swelling size, mouth opening, pain, lymph node condition and body temperature were carried out during the assessment visits on the third day and the fifth day. If clinical improvement was present- the patient was advised anyone of the following treatments that suited his/her clinical condition. The tooth was treated either by root canal treatment or extraction. The subject’s whose clinical condition was not improved on the third day was advised to take the prescribed medicine for two more days and to come for dental checkup on the fifth day. Results: The efficacy of both therapies was similar. No significant difference in adverse drug reaction. Patient compliance was in favour of ofloxacin and ornidazole group. Cost of fixed dose combination of ofloxacin and ornidazole therapy was slightly cheaper than amoxicillin and metronidazole. Conclusion: We conclude that the efficacy of both the therapies was similar with no significant difference in adverse drug reaction. The patient compliance was in favor of oflaxacin and ornidazole group of drugs which was relatively cheaper than amoxicillin and metronidazole.

Protective effects of royal jelly on the histomorphologic, oxidative stress and sperm parameters in Ofloxacin treated rat

Royal jelly is produced by worker bees as nutrition for bee larvae and adult queens and has also been shown to have protective effects against antibiotics. The aim of this investigation was to determine protective effect of royal jelly on the reproductive functions of male rats treated with ofloxacin. In this experiment, 32 mature male albino rats were randomly allocated into four groups (n = 8): control, ofloxacin only, royal jelly only, and ofloxacin with royal jelly. The results revealed that ofloxacin alone caused significant decreases (P < 0.05) in follicle-stimulating hormone, luteinizing hormone, testosterone, sperm count, sperm viability, total thiol molecules, and total antioxidant capacity compared to the control group. However, levels of immature sperm, DNA impaired sperm, malondialdehyde and nitric oxide were significantly increased (P < 0.05) in the ofloxacin group compared to the control. In the ofloxacin with royal jelly group, no significant increases or decreases were observed. Royal jelly has protective effects on reproductive function of male rat treated with ofloxacin.

Ceftriaxone, ofloxacin or both in the treatment of enteric fever

Introduction: Enteric fever is a common diagnosis in febrile patients admitting to the hospital of Nepal. The treatment of enteric fever, though looks straightforward, in recent times has been complicated by emerging resistance to various antibiotics including fluoroquinolones and cephalosporins.Methods: This was a randomized clinical study done at Shree Birendra Hospital from January 2011 to December 2011. Patients with with high grade fever, headache, relative bradycardia, abdominal pain, diarrhoea or constipation with normal to low leukocyte count were clinically diagnosed as Enteric fever and were randomized to either ofloxacin or ceftriaxone group, both well accepted first line treatment for enteric fever and observed for at least five days before the addition of the second drug that is ceftriaxone in ofloxacin group and ofloxacin in ceftriaxonegroup and the response to the drug was noted in terms of defervescence of fever.Results: Total 50 patients were enrolled, 25 in each treatment group. After five days, six patients in Ceftriaxone group needed addition of Ofloxacin and two patients in Ofloxacin group needed Ceftriaxone. The average fever defervescence time in Ceftriaxone group was 3.88 days and in Ofloxacin group was 3.04 days. All patients were afebrile by 9 days of antibiotics.Conclusions: Fever defervescence time with Ofloxacin was lesser than ceftriaxone group and need of supplementary antibiotic is lesser in ofloxacine group. So, ofloxacin can be recommended as 1st line drug for enteric fever.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/37-40DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9092

Gatifloxacin Versus Ofloxacin for the Treatment of Uncomplicated Enteric Fever in Nepal: An Open-Label, Randomized, Controlled Trial

BackgroundFluoroquinolones are the most commonly used group of antimicrobials for the treatment of enteric fever, but no direct comparison between two fluoroquinolones has been performed in a large randomised trial. An open-label randomized trial was conducted to investigate whether gatifloxacin is more effective than ofloxacin in the treatment of uncomplicated enteric fever caused by nalidixic acid-resistant Salmonella enterica serovars Typhi and Paratyphi A.Methodology and Principal FindingsAdults and children clinically diagnosed with uncomplicated enteric fever were enrolled in the study to receive gatifloxacin (10 mg/kg/day) in a single dose or ofloxacin (20 mg/kg/day) in two divided doses for 7 days. Patients were followed for six months. The primary outcome was treatment failure in patients infected with nalidixic acid resistant isolates. 627 patients with a median age of 17 (IQR 9–23) years were randomised. Of the 218 patients with culture confirmed enteric fever, 170 patients were infected with nalidixic acid-resistant isolates. In the ofloxacin group, 6 out of 83 patients had treatment failure compared to 5 out of 87 in the gatifloxacin group (hazard ratio [HR] of time to failure 0.81, 95% CI 0.25 to 2.65, p = 0.73). The median time to fever clearance was 4.70 days (IQR 2.98–5.90) in the ofloxacin group versus 3.31 days (IQR 2.29–4.75) in the gatifloxacin group (HR = 1.59, 95% CI 1.16 to 2.18, p = 0.004). The results in all blood culture-confirmed patients and all randomized patients were comparable.ConclusionGatifloxacin was not superior to ofloxacin in preventing failure, but use of gatifloxacin did result in more prompt fever clearance time compared to ofloxacin. Trial registration: ISRCTN 63006567 (www.controlled-trials.com).

Topical azithromycin or ofloxacin for endophthalmitis prophylaxis after intravitreal injection

BackgroundThe number of patients who have undergone intravitreal injections has increased enormously in recent years, but a consensus is still lacking on prophylaxis for endophthalmitis. The aim of this prospective, observational study was to evaluate the prophylactic effect of azithromycin eye drops versus ofloxacin eye drops.MethodsThe study was conducted in five hospitals in Spain and included all patients undergoing intravitreal injections of triamcinolone, bevacizumab, ranibizumab, or pegaptanib over one year. Patients received azithromycin 15 mg/g eye drops (twice daily on the day prior to injection and for another 2 days) or ofloxacin 3 mg/g eye drops (every 6 hours on the day prior to injection and for another 7 days).ResultsIn the azithromycin group, there were 4045 injections in 972 eyes of 701 patients. In the ofloxacin group, there were 4151 injections in 944 eyes of 682 patients. There were two cases of endophthalmitis (0.049%) in the azithromycin group and five (0.12%) in the ofloxacin group. The odds ratio of presenting with endophthalmitis in the ofloxacin group compared with the azithromycin group was 2.37 (95% confidence interval [CI] 1.32–3.72, P < 0.001). There were two cases of noninfectious uveitis after triamcinolone injection in the azithromycin group (0.049%) and two (0.048%) in the ofloxacin group; no significant differences were observed (odds ratio 0.902, 95% CI 0.622–1.407, P = 0.407). Conjunctival hyperemia was observed in 12 cases in the azithromycin group and none in the ofloxacin group.ConclusionThe risk of endophthalmitis was significantly greater with ofloxacin than with azithromycin. These findings provide a valuable addition to the ever-increasing pool of information on endophthalmitis prophylaxis after intravitreal injection, although further large-scale studies are required to provide definitive conclusions.

Evaluation of Efficacy of Topical Povidone-Iodine and Different Types of Fluoroquinolones in the Sterilization of Bacterial Flora on the Conjunctiva

To compare the sterilization effectivity of topical povidone-iodine, ciprofloxacin, and ofloxacin on the conjunctival bacterial flora. One hundred sixty-four eyes of 164 patients scheduled for cataract surgery were prospectively analyzed. Conjunctival cultures were obtained 1 day before the surgery without any topical application in all patients. Conjunctival flora was examined in 53 eyes of 53 patients (Group I) 15 min after 5% topical povidone-iodine application on the day of the surgery. Fifty-four eyes of 54 patients (Group II) received 1 drop 0.3% ciprofloxacin at 12 pm 1 day before the operation and 4 drops at 15 min intervals on the day of the surgery. Another 57 eyes of 57 patients (Group III) received 0.3% ofloxacin in the same application mode as ciprofloxacin. Conjunctival cultures were taken in all patients 15 min after last drop of topical antibiotic application. Only coagulase-negative staphylococci were isolated from 75.4% in Group I, 72.2% in Group II, and 59.6% in Group III on pretreatment culture. Different types of bacteria such as Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Proteus spp., Micrococcus spp. were identified in other patients. Pretreatment conjunctival flora of Group I and Group II were similar (P>0.05), but it was significantly different in Group III (P<0.05). After topical application no bacterial growth was observed in 77.3% in Group I, 92.5% in Group II, and 66.6% in Group III. The difference between Group I and III was insignificant (P>0.05), but bacterial eradication effectiveness was significantly higher in Group II than that of other groups (P<0.05). Post-treatment cultures showed same bacterial flora as pretreatment cultures in 14.9% in Group I, 1.8% in Group II, and 19.2% in Group III. The difference between Group I and Group III was statistically insignificant (P>0.05) and the difference between Group II and other groups was statistically significant (P<0.05). Four eyes (7.5%) showed different types of bacterial growth from pretreatment flora in Group I, which were seen in 3 eyes (5.5%) in Group II and in 8 eyes (14%) in Group III. The differences between groups were statistically insignificant (P>0.05). Ciprofloxacin seems to be more effective in conjunctival sterilization. In consideration with high variety of bacterial flora in pretreatment period in ofloxacin group, ofloxacin seems to be superior to povidone-iodine on the reduction of bacterial flora on the conjunctiva.

The efficacy of a four-week, ofloxacin-containing regimen compared with standard WHO-MDT in PB leprosy

To compare the efficacy of a 4-week ofloxacin-containing regimen and the standard WHO-MDT regimen for PB leprosy, in terms of the rate and timing of relapse after treatment completion. 124 PB patients were enrolled in a randomised, double-blind trial. Of these, 66 received the standard 6-month WHO-MDT regimen, whereas 58 received 28 daily supervised doses of rifampicin 600mg + ofloxacin 400 mg, plus 5 months of placebo. Patients were regularly monitored for clinical response and for signs of relapse after treatment completion. Patients enrolled in the ofloxacin group had a mean follow-up of 10.8 years (628 patient-years) with 1 early relapse at 3 years after treatment completion. On relapse, this patient remained smear negative but was reclassified by current WHO criteria (> or =6 skin lesions) as multibacillary (MB). Patients on the WHO-MDT regimen had a mean follow-up of 11.3 years (749 patient-years) with two late relapses at 8 and 12 years, both still classified as PB on relapse. In conclusion, both regimens appeared generally efficacious, and, in particular, resulted in few relapses.