Topical Ofloxacin Research Articles

Comparative Effectiveness of the Oral versus Topical Ofloxacin to Reduce the Discharge in Chronic Suppurative Otitis Media: A Randomized Control Trial

Objective: The objective of the study was to assess the reduction rate of discharge in chronic suppurative otitis media with the use of oral vs topical Ofloxacin. Methodology: It was a randomized control trial conducted in the Department of Otorhinolaryngology Head and Neck surgery PIMS Islamabad from 26-06-2019 to 26-12-2019. The study was commenced with the approval from the ERB (Ethical Review Board). Non-probability consecutive sampling technique was used. Sample size was calculated using WHO calculator which was 98 with 49 patients in each group A & B. Participants of group A received topical Ofloxacin whereas, in group B received oral/systemic Ofloxacin. Efficacy of oral and topical drug was compared after two weeks of the start of the treatment. Data analysis was done using SPSS version 23. Results: According to gender distribution, there were 67.3% (n=33) males and 32.7% (n=16) were females in group A whereas, there were 61.2% (n=30) males and 38.8% (n=19) were females in group B. The mean age of the participants of group A was recorded as 27.0 years ± 9.4 and 26.6 years ± 10.1 in group B. Mean disease duration in group A was recorded as 2.6 years ± 2.1 and 2.4 years ± 1.9 in group B. A pus discharge was recorded in 73.5% (n=36) patients, pus and blood stained discharge in 26.5%, (n=12), 89.8% (n=44) had redness and 12.2% (n=6) had edema on examination. The values for group B were 95.9% (n=47), 4.1% (n=2), 46.9% (n=23) and 6.1% (n=3), respectively. After two weeks treatment, the outcomes were considerably enhanced in patients treated with topical ofloxacin in comparison to those treated with oral ofloxacin (p<0.05 across all groups). Conclusion: Topical ofloxacin is a better agent as compared to orally available in resumption of discharge in CSOM. More, multicenter studies with an enlarged sample size are suggested to strengthen the evidence.

Electroretinography, Ocular Ultrasonography, and Phacoemulsification of Bilateral Cataracts in Two Juvenile Loggerhead Sea Turtles (Caretta caretta) of the Mediterranean Region.

Bilateral cataracts were diagnosed in two rescued juvenile, immature loggerhead sea turtles (Caretta caretta), weighing 1.65 and 1.7 kg. Both animals showed vision impairment and difficulty in feeding without assistance. In fact, they did not notice the presence of the food in the tank unless it was brought close to touching the mouth. Ocular ultrasonography and electroretinography showed no lesions of the vitreal body and retinal layer, therefore, both animals were candidates for bilateral cataract surgery. Topical administration of tropicamide + phenylephrine alternating with rocuronium resulted in only minimal mydriasis. Administration of intracameral rocuronium did not improve mydriasis. Phacoemulsification using a one-handed technique was performed bilaterally with a phacoemulsification device (Sovereign, AMO (Abbott Medical Optics®). After surgery, the systemic anti-inflammatory drug (dexamethasone 0.2 mg/kg, IM daily for one week) and antibiotics (enrofloxacin 10 mg/kg IM q 72 h, for 4 weeks; ceftazidime 20 mg/kg IM q 72 h for 3 weeks) were administered. Topical ofloxacin, flurbiprofen and tobramycin/dexamethasone were instilled TID for 4 weeks. Both turtles regained vision in both eyes. Results at a 10-month follow-up were satisfactory. This is the first report of cataracts in turtles rescued in the Mediterranean Sea and the first description of surgical treatment of cataracts in loggerhead turtles so young.

Bidirectional corneo-conjunctival transposition for large and deep canine corneal wound healing

This case report describes satisfactory correction of deep and large canine corneal ulcerations by application of bidirectional corneo-conjunctival transposition (CCT). A 12-year-old spayed female Maltese dog with a large corneal descemetocele, perforation, and blepharospasm of the right eye was referred to Chungbuk National University Veterinary Teaching Hospital. More than half of the thickness of the cornea was damaged, and the ulcer was progressive. On ophthalmic examination, menace response and dazzle reflex were absent. No corneal melting was observed. As the patient had large and deep corneal ulcers, traditional one-sided CCT was not sufficient to cover the wound lesion. To increase corneal transparency after recovery, we decided to perform bidirectional CCT from 12 o’ clock on the dorsal side to 7 o’ clock on the ventral side. The dog was medicated with topical eye drops, ofloxacin, atropine, and moxifloxacin before surgery. Debridement with a diamond burr was then performed around the descemetocele. Five weeks after surgery, the dazzle reflex was restored as the blood vessel receded from the cornea to the conjunctiva. Eight weeks after surgery, corneal transparency and corneal stability were gradually restored, but not completely. Bidirectional CCT provides structural support and helps corneal wound healing in large canine corneal ulceration.

A comparative study on the pharmacovigilance scoring of causality assessment grading and staging of topical pharmacotherapy of ofloxacin 0.3% ophthalmic solution in bacterial conjunctivitis and ofloxacin 0.3% otic solution in otitis externa

Background: Topical pharmacotherapeutic modalities would minimalize systemic adverse effects. Ofloxacin, the bactericidal racemic mixture, has inhibitory effects on DNA gyrase, DNA topoisomerase IV and IL-1α, IL-6, and IL-8. This was a comparative study for pharmacovigilance scoring of causality assessment grading and staging of topical ofloxacin pharmacotherapy in bacterial conjunctivitis and otitis externa.Methods: Group A=50 bacterial conjunctivitis patients were prescribed topical ophthalmic 0.3% ofloxacin, 2 drops in each eye after every 3 hours for 2 days, and 2 drops in each eye after every 6 hours for next 5 days; and group B=50 otitis externa patients were prescribed topical otic 0.3% ofloxacin, 3 drops in each ear after every 6 hours for first 2 days, and 5 drops in each ear after every 12 hours for next 5 days. Comparative adverse drug reactions occurrence, like transient ocular burning or discomfort, ocular irritation, redness, stinging, pruritis, photophobia, ocular watering and dryness in group A, and pruritis, headache, dizziness, mild ear pain, rashes, and hypersensitivity reactions in group B, were analysed with adverse event case report forms, on days 0, 3, 5, 7, 10, 15, 30, and on follow-ups, with causality assessment scores, from adverse drug reactions grading and staging.Results: The occurrence of adverse effects were statistically non-significant, in both groups, with causality assessment scoring for group A: -11, none on average=Unlikely causality, and group B: -11, none on average= Unlikely causality.Conclusions: Topical ofloxacin therapy in group A and group B patients, were safe and tolerable; with nil causality of association of adverse drug reactions.

Refractory chronic otitis media and mixed hearing loss due to infection with levaquin-resistant KERSTERSIA GYIORUM: A case report and review of the literature

A 39-year-old Caucasian male, with a past medical history of purulent drainage of both ears as an infant and multiple tympanostomy tube placements in childhood, presented our ENT clinic complaining of right ear fluid drainage and hearing loss for the past year. Two months prior to presentation, he began to have increased fluid drainage from the right ear. Examination of the right external auditory canal showed thick, white fluid and a tympanic membrane perforation with a protruding small mass. A sample of the fluid was obtained. Culture of the right EAC fluid grew aerobic, gram-negative rods, identified as Kerstersia Gyiorum. The patient was initially treated with topical ofloxacin and topical prednisolone drops. He was seen again 4 weeks later and was noted to have persistent fluid drainage from the right ear. At this time, oral sulfamethoxazole-trimethoprim was added to his regimen Keywords: Chronic otitis media; hearing loss; treatment resistant otitis media; uncommon infectious microorganism; Kerstersia Gyiorum

Topical versus systemic antibiotics for chronic suppurative otitis media.

Topical versus systemic antibiotics for chronic suppurative otitis media.

Recurrent Achilles tendinitis after ophthalmic ofloxacin use

A 67-year-old woman developed recurrent fluoroquinolone-induced Achilles tendinitis after using topical ofloxacin for delayed sequential bilateral cataract surgeries, 2 weeks apart. Within days of the first surgery, she noted onset of left foot pain. Clinical examination and magnetic resonance imaging ultimately confirmed recurrence of left Achilles tendinitis. Her first episode of Achilles tendinitis occurred 13 years prior, after oral ciprofloxacin use for acute appendicitis. To our knowledge, this is the second report of topical ophthalmic-induced fluoroquinolone tendinopathy.

Travmatik korneal abrazyon hastalarında Dekspantenol kullanımının hasta konforuna olan etkisi

Objective: The aim in this study was to investigate if the use of Dexpanthenol could play a role in the relief of pain in the treatment of corneal abrasions (CA). Methods: Patients presenting to the BLINDED with a diagnosis of CA were conducted in this retrospective, case-control study. A detailed ocular examination was done and pain severity was assessed using a visual analogue scale (VAS) score. In group 1, subjects were treated with only topical ofloxacin %0.3 while subjects in group 2 were treated with topical ofloxacin %0.3 and dexpanthenol. Foreign body sensation, photophobia, excessive lacrimation and VAS were documented at follow up examinations. Results: 70 patients were allocated into group 1 and 68 patients were allocated into group 2. At each visit, there were significant differences in VAS scores between the groups (p<0.005). VAS scores were lower in group-2. There were no statistically significant differences between two groups in terms of photophobia, foreign body sensation, excessive lacrimation (p>0.05). All patients were free of any complications. Conclusion: Although it was shown that adding topical dexpanthenol to the treatment regimen could permit faster pain relief in treating CAs, the prospective studies should be done. Key words: Traumatic corneal abrasion, Dexpanthenol, Visual analogue scale.

Prophylactic intracameral cefazolin and postoperative topical moxifloxacin after cataract surgery: endophthalmitis risk reduction and safety results in a 16-year study.

This large retrospective observational study describes the evolution of the rates of postoperative endophthalmitis in cataract surgery in a 16-year period, and compares them before and after two different changes in the prophylaxis protocol of a general hospital in Barcelona, Spain. This study included all the phacoemulsification procedures performed from January 2002 to December 2017. In January 2004, intracameral cefazolin at the end of the surgery was added to the prophylaxis protocol of cataract surgery. In January 2011, topical postoperative ofloxacin was replaced by topical moxifloxacin. Cumulative incidences of postoperative endophthalmitis before and after the addition of intracameral cefazolin and the change of ofloxacin by moxifloxacin as postoperative topical treatment were compared. The study included 55,984 surgeries. In the period after the introduction of intracameral cefazolin (2004-2010), the cumulative incidence of endophthalmitis was 0.047% (95% CI 0.019-0.099%), significantly lower than in the previous period. From January 2011 to December 2017, after the postoperative change of topical ofloxacin by moxifloxacin, the cumulative incidence dropped to 0.0037% (95% CI 0.000468-0.01862%), with a relative risk reduction between both periods of 91.3%. An intracameral bolus of cefazolin was a very effective prophylaxis of endophthalmitis in cataract surgery. The continuous surveillance and prophylaxis protocol revision over time further reduced the incidence of this complication to extremely low levels.

Microbial Keratitis and Ocular Surface Disease: A 5-Year Study of the Microbiology, Risk Factors and Clinical Outcomes in Sydney, Australia

ABSTRACTPurpose: To report the microbiological and clinical profiles, and outcomes of patients with microbial keratitis who had ocular surface disease (OSD) at the Sydney Eye Hospital, Australia over a 5-year period.Methods: A retrospective case-series study was conducted. Patients diagnosed with microbial keratitis who had a history of OSD (dry eye, blepharitis, Steven Johnson syndrome (SJS) and ocular cicatricial pemphigoid (OCP)) from 1st January 2012 to 31st December 2016 were identified from hospital coding and pathology data. Data were extracted from the medical records.Results: 189 eyes from 171 patients with a mean age of 60 ± 19 years (range 20–96 years) were included. OSD included blepharitis (79%), dry eye (25%), SJS (4%) and OCP (2%). Coagulase-negative Staphylococcus (CoNS) (48%) were the most common isolated microorganism, made up of mostly Staphylococcus epidermidis (n = 37, 48%), Staphylococcus capitis (n = 16, 21%), and Staphylococcus warneri (n = 10, 13%). Median visual acuity at initial presentation was 0.52 logMAR and 0.30 logMAR at final visit. Median healing time was 12 days (IQR 6–27). The most common initial antimicrobial treatment prescribed was a combination of topical fortified cephalothin and gentamicin (n = 65, 34%); or topical ofloxacin (n = 56, 30%). Complications occurred in 69 eyes (37%), mainly non or slow-healing epithelial defects (n = 53, 43%) or corneal perforations (n = 24, 20%); and were more common in the elderly (n = 48/69, 70%).Conclusion: Microbial keratitis can affect those with OSD. In our setting, CoNS were the main organisms identified. Furthermore, patients prescribed a combination therapy of fortified antibiotics had poorer outcomes compared to monotherapy fluoroquinolones.

Topical antibiotic therapy in chronic rhinosinusitis: an update.

Topical antibiotic therapies have been investigated for their use in chronic rhinosinusitis (CRS). However, society guidelines and evidence-based medicine reviews have recommended against the use of topical antibiotic therapy based on randomized controlled trials (RCTs). The purpose of this article is to review recent clinical research published since the aforementioned guidelines were published. A structured literature review was performed on clinical studies published in the last 5 years investigating the use of topical antibiotic therapies. One double-blinded, randomized controlled trial (DB-RCT) supported the use of tobramycin using a vibrating aerosolizer; 1 non-blinded non-randomized controlled prospective trial lent support to use of topical ofloxacin for its anti-biofilm properties; and 1 meta-analysis found mupirocin irrigations to be beneficial in the short term. One Cochrane Review was unable to make a recommendation as no trial met the inclusion criteria. An additional systematic review found limited evidence to support the use of topical antibiotics with the exception of mupirocin irrigations that may be considered in Staphylococcus aureus infections. Two retrospective studies found that topical antibiotics change bacterial cultures of the sinuses. There is additional evidence to support continuing investigation of topical antibiotic therapies. Further, larger RCTs are required to establish the efficacy of topical antibiotic therapies.

Abordagem desafiante de uma úlcera de córnea neurotrófica e por exposição

ABSTRACT This study aims to describe a challenging clinical case of a patient with a neurotrophic and exposure corneal ulcer. A 75-year-old male patient, with history of right eye (RE) limbic stem-cell insuficiency due to complications of recurrent herpetic keratitis, underwent successful limbic stem-cell transplantation in 2008. In 2010, an uneventful penetrating keratoplasty was performed. After a cataract phacoemulsification surgery with intraocular lens implantation done in 2011, best corrected visual acuity was 20/20, and remained stable until 2015. In July 2015, the patient developed right facial nerve palsy and two months later, presented with an extensive central corneal ulcer, with a significant thinning of central stroma, without infection signs, but with an imminent risk of perforation. Treatment with topical ofloxacin and intensive ocular lubrification was started in association with permanent ocular oclusion. Due to lack of any clinical improvement, treatment with RGTA [Poli (carboximetilglucose) sulfate, dextrano T40] (Cacicol®, Thea) was started. After two weeks of treatment, a complete reepithelization and partial stromal filling was observed. Continued monitoring and treatment with artificial tears was maintained, with no recurrence observed. There is an unmet need for a medical therapy that could help corneal neurotrophic ulcers to heal. The presented clinical case shows that the approach of targeting extracellular matrix can be effective in the reepithelialization of neurotrophic and exposure corneal ulcer that do not respond to conventional treatments.

Episcleritis in a patient with mucosal melanoma treated with interferon alfa-2b and radiotherapy: a case report

BackgroundMucosal melanoma of the head and neck is a rare malignant tumor associated with a poor prognosis. Surgery, chemotherapy, radiotherapy, and biotherapy are common strategies for treating mucosal melanoma of the head and neck. Episcleritis is an idiopathic, immune-mediated disease, and is classified into two types: simple episcleritis and nodular episcleritis.Case presentationIn this case report we describe ocular changes involving simple episcleritis in a 65-year-old Chinese man with mucosal melanoma of the head and neck after treatment with interferon alfa-2b and radiotherapy. On the third day of interferon alfa-2b treatment, he began to develop simple episcleritis in his left eye. Moreover, the percentage of CD3+ T cells in lymphocytes from blood was increased after interferon alfa-2b treatment. After approximately 6 days, the symptoms of eye pain, hyperemia, and edema disappeared gradually. Then, after radiotherapy was performed three times, he again developed episcleritis in his left eye. The same symptoms of hyperemia and edema occurred again; CD3+ T cell frequency was also at a higher level. After approximately a week, all the symptoms disappeared completely. Simple treatment involving topical ofloxacin and phenylephrine was administered during the two periods of episcleritis.ConclusionEpiscleritis in this patient might have been due to the treatment with interferon alfa-2b and radiotherapy, leading to an increase in the level of CD3+ T cells and activation of immune system cells, which provides the guide for clinical clinicians.

Assessment of efficacy of Topical ofloxacin compared with gentamicin in the treatment of external ocular infection: a comparative study

Assessment of efficacy of Topical ofloxacin compared with gentamicin in the treatment of external ocular infection: a comparative study

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.

Otitis in a cat associated with Corynebacterium provencense

BackgroundThe role of corynebacteria in canine and feline otitis has not been investigated in detail; however, members of this genus are increasingly recognized as pathogens of otitis in both human and veterinary medicine.Case presentationHere we report the first case of feline otitis associated with the recently described species Corynebacterium provencense. A seven-month old cat presented with a head tilt and ataxia was diagnosed with peripheral vestibular syndrome associated with an otitis media/interna. This took place 6 weeks after resection of a polyp, having initially shown a full recovery with topical ofloxacin and glucocorticoid treatment. Bacteriology of an ear swab yielded a pure culture of corynebacteria, which could not be identified at the species level using routine methods. However, the 16S rRNA gene sequence was 100% identical to the recently published novel corynebacterium species, Corynebacterium provencense. Whole genome sequencing of the cat isolate and calculation of average nucleotide identity (99.1%) confirmed this finding. The cat isolate was found to contain additional presumptive iron acquisition genes that are likely to encode virulence factors. Furthermore, the strain tested resistant to clindamycin, penicillin and ciprofloxacin. The cat was subsequently treated with chloramphenicol, which lead to clinical improvement.ConclusionCorynebacteria from otitis cases are not routinely identified at the species level and not tested for antimicrobial susceptibility in veterinary laboratories, as they are not considered major pathogens. This may lead to underreporting of this genus or animals being treated with inappropriate antimicrobials since corynebacteria are often resistant to multiple drugs.

Topical versus systemic antibiotics for chronic suppurative otitis media

Topical versus systemic antibiotics for chronic suppurative otitis media

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).

Epidemiological Features and Antibiotic Resistance Patterns of Haemophilus influenzae Originating from Respiratory Tract and Vaginal Specimens in Pediatric Patients

Study ObjectiveHaemophilus influenzae (H. influenzae) is a common pathogen of respiratory tract infections in children, however, as a possible cause of vulvovaginitis in prepubertal girls, its epidemiological features, antibiotic-resistance patterns, and treatment are seldom noted. Design, Setting, Participants, Interventions, and Main Outcome MeasuresSpecimens obtained from patients were inoculated on Haemophilus selective medium; and drug-sensitivities tests were determined using the disk diffusion method. A cefinase disk was used to detect β-lactamase. ResultsA total of 610 H. influenzae strains, 81.6% (498/610) from the respiratory tract and 18.0% (110/610) from the vagina, were identified in the Children's Hospital in 2015. The age of the children with respiratory tract strains were significantly younger than those with vaginal strains (P < .001). The H. influenzae isolation rate in May was the highest. The β-lactamase positive rate was 51.5% (314/610), and 52.5% (320/610) were resistant to ampicillin. The susceptibilities rates to cefuroxime, ampicillin/sulbactam, cefotaxime, clarithromycin, and sulfamethoxazole-trimethoprim were 72.1% (440/610), 95.9%, 96.4% (588/610), 81.8% (499/610), and 36.4% (222/610), respectively. Higher resistance to ampicillin, cefuroxime, clarithromycin, and sulfamethoxazole-trimethoprim were found in respiratory tract strains, compared with vaginal strains (P < .05). All of the patients with H. influenzae in the respiratory tract were cured with oral or intravenous β-lactam antibiotics. Of all patients with vaginal strains, 50% (55/110) were cured with topical ofloxacin gel, and 44.5% (49/110) were cured with oral β-lactam antibiotics. ConclusionThe drug-resistance rates of H. influenzae isolated from vagina were lower than those from the respiratory tract. Topical ofloxacin gel or oral β-lactam antibiotics are effective treatments to eliminate the H. influenza causing infection in the vagina.

Efficacy of Topical Ofloxacin 0.3 % Administration on Conjunctival Bacterial Flora in Diabetic Patients Undergoing Intravitreal Injections

ABSTRACTPurpose: This prospective, randomized case series study aims to evaluate the efficacy of ofloxacin 0.3% eye drops in eradication of conjunctival bacterial flora in diabetic patients undergoing intravitreal injections (IVI). Methods: Ninety-two diabetic patients (92 eyes) scheduled to undergo intravitreal injection of ranibizumab due to diabetic macular edema were enrolled in the study. Patients were randomly assigned to three different groups. Group 1 (n=32) received ofloxacin eye drops the day before before IVI (four times); patients in Group 2 (n=29) were administered ofloxacin one hour before IVI (every 15 minutes), while Group 3 (n=31) comprised patients that received combined administration of ofloxacin both one day and one hour before IVI (eight doses). Samples were collected from the injection site before and after antibiotic administration. Culture results from BACTEC broth and positive cultures in blood agar and Sabouraud’s dextrose agar plates were measured. Results: In Group 1, BACTEC broth positive cultures decreased from 84.4% at baseline to 50% after ofloxacin administration (p=0.007), and blood agar positive cultures reduced from 65.63% to 34.38% (p=0.02). In Group 2, positive cultures significantly decreased in BACTEC broth (from 79.3% at baseline to 48.28%; p=0.027) and in blood agar (from 68.97% to 37.13%; p=0.034). In Group 3, positive cultures decreased from 77.42% at baseline to 32.26% (p=0.0008) and from 58.06% at baseline to 22.58% (p=0.009) in BACTEC broth and blood agar, respectively. No microorganisms were isolated from Sabouraud’s dextrose agar plates. Conclusions: The combined one day/one hour (eight doses) ofloxacin administration in diabetic patients is extremely effective in reducing conjunctival bacterial flora. The application of topical ofloxacin for one day or one hour before IVI is also significantly effective.