Treatment Of Ocular Infections Research Articles

Molecular Characterization of Bacterial Agents Causing External Ocular Infections Isolates of Patients in a Third Level Hospital.

Empirical use of antibiotics in the treatment of eye infections leads to bacterial pathogens becoming resistant to antibiotics; consequently, treatment failure and eye health complications occur. The aim of this study was to describe the phenotype and genotype of the resistance and adherence of bacterial agents causing eye infections in patients at Hospital Juárez de México. An observational, prospective, cross-sectional, and descriptive study was carried out in patients with signs and symptoms of ocular infection. Bacterial agents were isolated and identified by classical microbiology and mass spectrometry. Antibiotic resistance and adherence profiles were determined. Finally, resistance (mecA/SCCmec) and virulence (icaA and icaD) genes were detected in the Gram-positive population. The results showed that blepharitis was the most prevalent condition in the study population. A MALDI-TOF analysis revealed that Staphylococcus and Pseudomonas genus were the most prevalent as causal agents of infection. Resistances to β-lactams were detected of 44 to 100%, followed by clindamycins, aminoglycosides, folate inhibitors, and nitrofurans. A multiple correspondence analysis showed a relationship between mecA genotype and β-lactams resistance. The identification of SCCmecIII and SCCmecIV elements suggested community and hospital sources of infection. Finally, the coexistence of icaA+/icaD+/mecA(SCCmecIII) and icaA+/icaD+/mecA(SCCmecIV) genotypes was detected in S. aureus. The identification of resistant and virulent isolates highlights the importance of developing protocols that address the timely diagnosis of ocular infections. Herein, implications for the failure of antimicrobial therapy in the treatment of ocular infections in susceptible patients are analysed and discussed.

Microbiological spectrum and antibiotic susceptibility patterns of non-viral conjunctivitis over 16years at a tertiary eye care center in Southern India.

To determine the trends in the microbial spectrum and antibacterial susceptibility patterns of non-viral conjunctivitis over 16years. Microbiology data were reviewed from 2006-2021 for all the patients with clinically and culture-proven infectious conjunctivitis. Conjunctival swabs and/or conjunctival scrapings were collected for microbiological workup, and the demographic and antibiotic susceptibility data were extracted from the EMR (Electronic Medical Record). For statistical analysis, χ2-test was performed. Of the 1711 patients, 814 (47.57%) were culture positive and 897 (52.43%) were culture negative. Of the total culture-proven conjunctivitis cases, 775/814 (95.20%) were bacteria, and 39/814 (4.80%) were fungi. Among these bacterial isolates, 75.74% were gram-positive bacteria, while 24.26% were gram negative. The predominant gram-positive pathogens isolated were S. epidermidis (16.7%), S. aureus (17.9%) (p < 0.05), and S. pneumoniae (18.2%), while Haemophilus spp. (36.2%) (p < 0.05) was the most often isolated gram-negative bacteria (36.2%), and Aspergillus spp. was the most commonly isolated fungus (50%). The susceptibility of gram-positive bacteria to cefazoline increased from 90.46 to 98% (p = 0.01), whereas the susceptibility for gatifloxacin decreased in both gram-positive (81-41%; p < 0.0001) and gram-negative bacteria (73-58%; p = 0.02). Increasing resistance of ocular isolates to mainstay antibiotics is a concern, and this data can assist healthcare practitioners in making informed choices regarding the treatment of ocular infections with ophthalmic antibiotics.

Miconazole Nitrate loaded Soluplus®-Pluronic® nano-micelles as promising Drug Delivery Systems for Ocular Fungal Infections: In vitro and In vivo Considerations

Miconazole nitrate (MN) is a broad-spectrum antifungal agent which suffers poor solubility and impermeability to the ocular tissue which limits its use in the treatment of ocular infections especially fungal keratitis, which is considered one of the most prevailing ocular infections. The current study aims to utilize polymeric mixed nano-micelles for the ocular delivery of MN using 33 full factorial design by varying the ratios of Pluronic® P123, Pluronic® F127, and Tetronic® T701 while the monitored responses were particle size, cloud point (CP), encapsulation efficiency (%EE) and %released at 6 hours (%Q6) at pH 7.4. The optimized formula was incorporated with Soluplus® (SP) to further enhance the (%EE) and the resultant formula was assessed in vitro as well as in vivo against C. albicans in treatment of induced ocular candidiasis using rabbits as a model animal. Results revealed that the optimized formula which comprised F127 and P123 in a ratio of (2:1) when incorporated with SP (SP-MPM) resulted in an increase in %EE from 35.12±3.18 to 99.19±7.03 with a particle size of 44.39±2.68nm with a sustained release profile and stability for 3 months at 4±2°C. In vivo results demonstrated the enhanced ability of SP-MPM for treatment of ocular candidiasis with enhanced % inhibition and susceptibility to C. albicans compared to 0.2% MN suspension confirmed with histopathological examination of rabbit’s eyes after 7 days of treatment with the absence of any degenerative effect to the ocular tissue. Thus, it can be concluded that SP-pluronic mixed nano-micelles offer a successful and stable ocular delivery platform for antifungal drug MN ensuring both its safety and efficacy.

An ion-paired moxifloxacin nanosuspension eye drop provides improved prevention and treatment of ocular infection.

There are numerous barriers to achieving effective intraocular drug administration, including the mucus layer protecting the ocular surface. For this reason, antibiotic eye drops must be used multiple times per day to prevent and treat ocular infections. Frequent eye drop use is inconvenient for patients, and lack of adherence to prescribed dosing regimens limits treatment efficacy and contributes to antibiotic resistance. Here, we describe an ion‐pairing approach used to create an insoluble moxifloxacin–pamoate (MOX–PAM) complex for formulation into mucus‐penetrating nanosuspension eye drops (MOX–PAM NS). The MOX–PAM NS provided a significant increase in ocular drug absorption, as measured by the area under the curve in cornea tissue and aqueous humor, compared to Vigamox in healthy rats. Prophylactic and treatment efficacy were evaluated in a rat model of ocular Staphylococcus aureus infection. A single drop of MOX–PAM NS was more effective than Vigamox, and completely prevented infection. Once a day dosing with MOX–PAM NS was similar, if not more effective, than three times a day dosing with Vigamox for treating S. aureus infection. The MOX–PAM NS provided increased intraocular antibiotic absorption and improved prevention and treatment of ocular keratitis, and the formulation approach is highly translational and clinically relevant.

Ocular Fungi: Molecular Identification and Antifungal Susceptibility Pattern to Azoles

Background: Treatment of ocular infection by fungi has become a problematic issue, particularly in deep lesion cases, because of the limited available antifungals and emerging resistance species. Objectives: The present study was designed for molecular identification and studying the antifungal susceptibility pattern of ocular fungi. Methods: Fifty-three ocular fungal isolates, including Fusarium spp., Aspergillus spp., yeast spp., and dematiaceous fungi were collected. Initial identification of each sample was performed using routine mycological techniques. ITS1-5.8SrDNA-ITS2 and translation elongation factor (TEF)-1α regions were used for the identification and differentiation of ocular non-Fusarium and Fusarium fungal species, respectively. The antifungal susceptibility of itraconazole, voriconazole, and posaconazole was determined according to the CLSI guidelines (CLSI M38 and M60, 3rd ed.) for filamentous and yeast species, respectively. Results: Voriconazole and posaconazole showed excellent activity in all tested isolates; however, some of Fusarium, Aspergillus, and Curvularia strains showed minimum inhibitory concentration (MIC) ≥ 2 μg/mL. The itraconazole showed different results in all species, and high MICs (≥ 16 μg/mL) were found. Conclusions: Finally, in the present study, we tried to identify species involved in fungal ocular infection using the molecular methods, which highlighted the importance of precise identification of species to choose an appropriate antifungal regime. On the other hand, our findings showed that antifungal susceptibility test is effective to reliably predict the in vivo response to therapy in infections; however, in fungal ocular infection cases, the penetration of antifungals may contribute to predict the outcome.

Evaluating the potential of drug eluting contact lenses for treatment of bacterial keratitis using an ex vivo corneal model.

Corneal infections are treated by multiple instillations of eye drops each day. This study aims to investigate the effectiveness of ofloxacin-loaded contact lenses as prolonged release devices for the treatment of bacterial keratitis. Two silicone hydrogel contact lenses (SHCLs) Senofilcon A (ACUVUE OASYS®) and Narafilcon A (ACUVUE TRUEYE®) were modified by incorporation of ofloxacin alone or with vitamin E (VE). The drug uptake and in vitro release kinetics were investigated and the antibacterial efficacy was assessed against Staphylococcus aureus and Pseudomonas aeruginosa in an ex vivo rabbit corneal model. The in vitro studies showed a higher uptake (p ≤ 0.05) and longer duration of release by Narafilcon A lenses compared to the Senofilcon A lenses. The addition of VE led to a significant increase in duration of release (p < 0.05) for both lenses. The ex vivo studies confirmed the effectiveness of the ofloxacin-loaded lenses in the reduction of bacterial load to clinically insignificant levels and ofloxacin-vitamin E-loaded Narafilcon A lenses in the reduction of bacteria on the corneas to undetectable levels. Antibiotic-loaded lenses are effective in the treatment of ocular infections. Incorporation of vitamin E will sustain this effect and eliminate the need for multiple instillations of eye drops.

DEVELOPMENT AND EVALUATION OF AN IN SITU THERMOGELLING SYSTEM OF OFLOXACIN FOR CONTROLLED OCULAR DELIVERY

Objective: The purpose of this study was to develop an in situ ocular gel of ofloxacin which aimed to prolong corneal residence time while controlling drug release.&#x0D; Method: In situ gelling solutions were prepared from Poloxamer 407, a temperature-sensitive gelling polymer and to which, mucoadhesive polymers such as hydroxypropyl methyl cellulose 15 cps and polyvinyl alcohol (PVA) were included to provide corneal adhesion. Drug incorporated gels were prepared and evaluated for their appearance, pH, gelation temperature, and in vitro drug release studies.&#x0D; Results: Incorporation of the drug into the formulation increased the gelation temperature while the addition of mucoadhesive polymers decreased the gelation temperature. Increasing the concentration of bio-adhesive polymers retarded the release of ofloxacin from the poloxamer solutions and drug release was sustained over a period of 9 h. PVA had no significant effect on the gelation temperature and could not sustain the drug release for a longer duration. The in vitro release profiles of the drug from all the formulations could be best expressed by Higuchi’s equation which indicated that gels followed matrix diffusion process and drug release from gel formulations followed first-order process.&#x0D; Conclusion: The results showed that the developed system would be promising in the treatment of ocular infections with the combined advantages of ease of administration, the accuracy of dosing, increased bioavailability, and prolonged retention time.

Update and critical appraisal of topical azithromycin ophthalmic 1% (Azasite) solution in the treatment of ocular infection

Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite® (Inspire Pharmaceuticals, Inc, Durham, NC) is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite®) that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA) in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well established uses of AzaSite eye drops in the field of ocular infections.

EVALUATION OF OCULAR FILMS OF OFLOXACIN FOR ANTIBACTERIAL ACTIVITY

Objective: The current study emphasizes on the treatment of ocular infection with objectives of reducing the frequency of administration, obtaining controlled release and greater therapeutic efficacy of the drug (ofloxacin) using ocular films.Methods: Ocular films were designed by solvent evaporation method containing a different combination of polymers. The folding endurance (mechanical strength) was determined by the number of folds at a specific single place required to break the film into two parts. Thickness was measured using screw gauze. The surface pH was done by pH paper. The percentage moisture absorption was carried out by placing the ocular films in a desiccator containing ammonium chloride. Percentage moisture loss was carried out by placing the ocular films in the desiccator containing anhydrous calcium chloride. in vitro drug release study were carried by using a modified version of franz diffusion cell. Stability study were carried using stability chambers as per ICH guidelines. The antibacterial activity was performed by using male albino rabbits.Results: The thickness and folding endurance of the films were in the range of 44±1.1 to 92±1.8 and 4.5±0.6 to 6.8±0.3, respectively for different formulations. Surface pH was evaluated in the range of 6.6 to 7.2. Percentage moisture absorption and percentage moisture loss were evaluated in the range of 1.17±1.1 to 6.72±1.5 and 0.58±0.9 to 1.23±0.9 respectively. Microbial growth was not observed in any formulation during sterility testing. The drug release for different batch codes PAH, PBE, PCP, PDC, PEEH, and PFEC was found to be 96.2, 56.9, 93.4, 94.5, 98.4 and 95.9 % respectively up to 12 h. Ocular films of batch code PEEH was optimized for maximum drug release (98.4%). The antibacterial effect was noted periodically (01 to 05 d) after administration of sterile formulation in the treated eyes vs. control eyes of each rabbit. The optimized batch PEEH of ocular films reduced the infection and redness completely within 3 d in a single dose.Conclusion: The optimized formulation would be able to offer benefits such as increased residence time, prolonged drug release, reduced frequency of administration and improved patient compliance with complete removal of inflammation and redness from the cul-de-sac.

Corneal delivery of besifloxacin using rapidly dissolving polymeric microneedles.

Penetration of antibiotics into and through the cornea is a major limiting factor in the treatment of ocular infections. Several strategies are in vogue to overcome this limitation such as use of fortified drops, gels, and subconjunctival injections. Here, we present the fabrication of rapidly dissolving polymeric microneedle array to effectively deliver besifloxacin through the cornea. Microneedles were prepared using polyvinyl alcohol and polyvinyl pyrrolidone by the micromolding technique. The model fluoroquinolone antibiotic, besifloxacin, was loaded in 36 microneedles arranged in a 6 × 6 array format within a 1cm2 area. The average height and base width of microneedles was 961 ± 27 and 366 ± 16μm, respectively. Each microneedle array contained 103.4 ± 8.5μg of besifloxacin. Cryosectioning and confocal microscopy of excised human cornea revealed that microneedles penetrated to a depth of up to 200μm. Microneedles were found to completely dissolve in the cornea within 5min. Application of microneedles for 5min significantly (p < 0.05) improved the besifloxacin deposition and permeation through the cornea compared with free besifloxacin solution. Similarly, besifloxacin-loaded microneedles showed greater antibacterial activity in Staphylococcus aureus-infected cornea in comparison to free besifloxacin solution. Taken together, rapidly dissolving microneedles can be developed to effectively deliver besifloxacin to treat bacterial infections in the cornea and eye.

Development and Characterization of a Microemulsion System Containing Amphotericin B with Potential Ocular Applications.

Amphotericin B eye drops are widely used in the treatment of ocular infections. However, amphotericin's toxicity leads to low patient compliance and aggravation of symptoms. This work describes the development of a microemulsion system containing amphotericin B, aiming for its use in ocular applications. The microemulsion was developed by the titration technique. The physicochemical characteristics were determined with both loaded and unloaded amphotericin B-microemulsion. The nanostructures were analyzed by polarized light microscopy. The microdilution method was used to establish the minimum inhibitory concentration against fungal strains, and, therefore, evaluate the microemulsion activity. Additionally, in order to evaluate the microemulsion toxicity an in vitro toxicity assay against red blood cells was performed. The performed studies showed that the presence of amphotericin B loaded into the system did not induce serious changes in the physicochemical properties of the microemulsion when compared to the unloaded system. The spectrophotometric studies depicted amphotericin B-self-associated species, which allow predicting its behavior in vitro. The high pressure liquid chromatography results revealed high drug content entrapment in the microemulsion droplet. Finally, the amphotericin B-microemulsion in vitro susceptibility test showed high activity against Candida strains and a low toxicity profile against red blood cells when compared to Fungizone®. The physicochemical characterization of the microemulsion demonstrated that its characteristics are compatible with the topical ocular route, making it eligible for consideration as a new and interesting amphotericin B-deliverydosage form to be used as eye drop formulation.

Ofloxacin Loaded Electrospun Fibers for Ocular Drug Delivery: Effect of Formulation Variables on Fiber Morphology and Drug Release

Ofloxacin (OFL) loaded poly(ε-caprolactone) (PCL) and PCL: poly(butylene succinate) PBS fibers as a drug delivery system in the treatment of ocular infections were prepared by electrospinning. In particular, the effect of some formulation variables including polymer:drug ratio (9:1, 8:2 and 7:3 w/w), solvent systems like dichloromethane (DCM), N,N-dimethylformamide (DMF), N,Ndimethylacetamide (DMAc) and dimethylsulfoxide (DMSO), polymer blends of PCL:PBS at 80:20, 60:40 and 40:60 ratios on fiber morphology, fiber size were investigated. The morphology and diameter of the electrospun fibers were investigated by scanning electron microscopy (SEM) images also the thermal properties were evaluated by differential scanning calorimetry (DSC). The drug release behaviour from fibers and in vitro antibacterial activity were also studied. It was noticed that the average fiber diameter decreased with decreasing polymer amount in initial composition meanwhile the release of drug increased with increasing amount of drug in formulations. Solvent system of DCM:DMF at 80:20 ratio improved fiber morphology and resulted in a reduction in fiber diameter. It was found that smooth surface, flexible fibers with uniform morphology were obtained with 80:20 ratio of PCL:PBS compositions. All fibers showed a burst release of OFL. The initial amount of the released OFL was found to vary as a function of PCL:OFL ratio and polymer composition in the fiber. The microbiological activity of optimized formulation was evaluated using P. aeruginosa, S. epidermidis, S. Aureus and E. coli strains and the results of this study clearly demonstrated that freely released OFL from fibers inhibited the growth of the tested bacteria. The process of electrospinning had no adverse effect on the activity of incorporated drug in fibers.

Система постійної доставки протиінфекційного пептиду ЬЬ37 — потенційний новітній метод лікування очних інфекцій. Повідомлення 3. Протимікробна активність 1X37, що інкапсульований у кремнієві наночастки

<p style="text-align: justify;"><span style="color: #800000;"><span style="color: #800000; font-family: verdana, geneva; font-size: small;">https://doi.org/10.31288/oftalmolzh2014548</span></span> <p style="text-align: justify;"><span style="font-family: verdana, geneva; font-size: small;"><strong><span style="color: #800000;">The sustained delivery system of the antiinfection peptide LL37 — a potential new method of treatment of ocular infections. Report 3. Antimicrobial activity of LL37 encapsulated in silica nanoparticle</span></strong></span>

Clinical challenges of ocular anti‐microbial therapy

AbstractPurpose To discuss the different clinical challenges in ocular anti‐microbial therapy as they pertain to bacteria, fungi, viruses, and acanthamoeba.Methods An overview of how the different infections often seen and how available medications might be utilized.Results With the large number of medications available to ophthalmologists these days, deciding what medication to use can be complicated. The initial choice of fourth‐generation fluoroquinolones has raised questions about bacterial resistance. This may highlight the importance of cultures in cases where infections are not responding as expected. Recognition of certain infections, such as early acanthamoeba, which can look similar to herpetic keratitis, may be difficult. The use of newer diagnostic tests, such as PCR, may be helpful to ensure appropriate treatment is started in a timely fashion. This may also be helpful in targeting treatment in fungal infections. The use of long term wear contact lenses, such as with a keratoprosthesis, has raised questions as to whether antibiotics are efficiently reaching the corneal surface and treating biofilms that form on contact lenses. Understanding what flora is present in cases of long term contact use may allow clinicians to better prevent infections. There have also been many clinicians who have advocated the treatment of viral conjunctivitis to help reduce the number of lost work and school hours. There is still debate as to the efficacy of these treatments and how it might impact the continually growing cost of health care.Conclusion Newer testing modalities and understanding what long term use of ocular anti‐microbials does on the ocular surface will improve our treatment of ocular infections and hopefully prevent them too.

Drug-drug interaction between ciprofloxacin and diclofenac ophthalmic drops at ocular level

In present times, there has been interest in multi-drug combinations for treatment of ocular infections, which are more commonly antibiotics and analgesics. Ciprofloxacin and diclofenac sodium were used concomitantly and pharmacokinetic drug-drug interactions between them were studied. To investigate disposition kinetics of ciprofloxacin eye drops (0.3%) alone and with co-administration of diclofenac sodium eye drops (0.1%) for pharmacokinetic drug-drug interaction(s). A randomized clinical trial was conducted in 84 human volunteers and the aqueous humor samples were collected from the eyes at various time intervals and concentration of ciprofloxacin in aqueous humor was determined using a validated reversed-phase high performance liquid-chromatography/ultraviolet detection method. The results were subjected to statistical analysis to determine whether a statistically significant difference was observed between the two groups. The mean age of the patients in this study ranged from 40 to 83 years, and gender distribution was 46.0% female and 54.0% males. The maximum concentration of ciprofloxacin in aqueous humor observed was 0.47 ± 0.057 µg/ml at 0.83 h. While the maximum concentration with concurrent administration of ciprofloxacin with diclofenac sodium was 0.44 ± 0.00577 µg/ml at 0.25 h. Time to reach maximum concentration was decreased to 0.3 h. t1/2abs and tα1/2 were not significantly affected by co-administration of the ciprofloxacin eye drops with the diclofenac sodium eye drops (P = 0.73), however, t1/2βwas significantly affected (P = 0.036). Similarly, apparent volume of distribution, volume of central compartment, steady-state distribution volume, AUC0-t and MRT were also significantly reduced due to concurrent administration of the diclofenac sodium eye drops with the ciprofloxacin eye drops (P = 0.021, 0.0.017, 0.05, 0.01 and 0.04). On the other hand, the ocular Clt was significantly elevated (P = 0.04), while absorption rate constant (P = 0.58) was non significantly decreased due to concurrent administration of the diclofenac sodium eye drops, while Cmax was not significantly affected. Diclofenac sodium affects the pharmacokinetics of ciprofloxacin when co-administered with ciprofloxacin eye drops. Key words: Ciprofloxacin ophthalmic drops, pharmacokinetics drug-drug interaction, aqueous humor.

In-Vitro efficacy of antimicrobial agents used in the treatment of bacterial eye infections in Ibadan, Nigeria

Failure to cure eye infections, and reduced potency in topical antimicrobials had been observed in South Western Nigeria, this study sought to evaluate in vitro, the efficacy of antimicrobial agents in the treatment of ocular infections. A total of 46 ocular bacterial isolates were recovered from the diagnostic laboratory of the University College Hospital, Ibadan, from conjunctival swabs of patients having underlying eye diseases (Cataracts, glaucoma and esotrapia), and from patients presenting with other symptoms of eye infections. The pathogens incriminated were Staphylococcus aureus (73.5%), Coagulase negative Staphylococci (13.3%), Klebsiella species (10.3%), and Pseudomonas aeruginosa (2.0%). Disc diffusion tests (Bauer-Kirby method) were carried out using ciprofloxacin, gentamicin, chloramphenicol, erythromycin, augmentin, cefuroxime and levofloxacin. Broth dilution techniques were thereafter performed using gentamicin, chloramphenicol and ciprofloxacin. The microlide- erythromycin was 63.0% efficacious, augmentin and cefuroxime showed 71.1% and 76% efficacy. Minimum inhibitory concentrations (MIC) of commonly used topical antibiotics however showed different levels of resistance. Resistance to the aminoglycosides was marked, yielding 53.4% with MIC50= 8, MIC90 > 256, Resistance to chloramphenicol was even more marked 69.6% with MIC50= 16, MIC90= 64, the fluoroquinolones showed high efficacy- levofloxacin and ciprofloxacin showed 93.4% and 82.6% susceptibility respectively with MIC50 < 0.5, though slightly demonstrable resistance was observed (MIC90= 8). The study thus recommends the discontinuation of empirical therapy by physicians in order to stem the tide of resistance; it justifies the inclusion of the fluoroquinolones in susceptibility testing of ocular bacterial isolates, and its first line of choice if cure is warranted.doi: 10.4314/ajcem.v12i3.7

Assessment of Ocular Pharmacokinetics and Safety of Ganciclovir Loaded Nanoformulations

Ganciclovir (GCV) plays an important role in the treatment of ocular viral infections. A high dose results in dose-related toxicity including bone marrow suppression and neutropenia. The aim of the present study was to investigate the comparative potential of different mucoadhesive nano formulations for the topical ocular delivery of Ganciclovir. GCV mucoadhesive Nanoemulsions (GCV-NEs), chitosan nanoparticles (GCV-NPs), GCV mucoadhesive niosomal dispersion (GCV-NDs) were prepared by the reverse-phase evaporation technique. All of the three formulations were evenly round in shape with mean particle size in the range of 23-200 nm. These results indicated the nonirritant and nontoxic nature of the developed formulations. The achieved results may be useful for formulation development of GCV, which could be effective in the treatment of ocular infections by topical instillation.

Update and critical appraisal of the use of topical azithromycin ophthalmic 1% (AzaSite&amp;reg;) solution in the treatment of ocular infections

Azithromycin is an azalide that acts by binding to the 50S ribosomal subunit of susceptible microorganisms and interfering with microbial protein synthesis. Azithromycin is also noted by anti-inflammatory and immunomodulatory activity. AzaSite® (Inspire Pharmaceuticals, Inc, Durham, NC) is azithromycin ophthalmic solution, 1% formulated in polycarbophil (the aqueous mucoadhesive polymer contained in DuraSite®) that delivers high and prolonged azithromycin concentrations in a variety of ocular tissues, including the conjunctiva, cornea and particularly the eyelid. AzaSite was approved by the Food and Drug Administration (FDA) in the US in 2007, for the treatment of bacterial conjunctivitis caused by susceptible isolates. This article aims to evaluate the peer-reviewed published scientific literature and to define well-established uses of AzaSite eye drops in the field of ocular infections.

Erratum

Erratum Utine CA. Update and critical appraisal of the use of topical azithromycin ophthalmic 1% (AzaSite®) solution in the treatment of ocular infections. Clin Ophthalmol. 2011;5:801-809.Table 2 inaccurately states that Bremond-Grignac used AzaSite® in their study. The ophthalmic preparation used was in fact Azyter®. Original Article

Comparative Efficacy Of Topical Ciprofloxacin On Staphylococcus Aureus and Pseudomonas Aureginosa in vitro

Ciprofloxacinis often considered drug of first choice in the treatment of bacterial keratitis.Most of the ocular infections are caused by Staphylococcus aureus and Pseudomonas aeruginosa. This study set to compare the efficacy of ciprofloxacin on these two microorganisms in vitro. The “agar well diffusion” and the 10-fold serial dilution techniques were used respectively for the tests. Results of sensitivity test showed that P. aeruginosa aeruginosa had a higher meanzone of inhibition(4.72cm) than S. aureus (3.73cm), showingthat ciprofloxacin ismore efficacious against P. aeruginosathanagainst S. aureus. Ciprofloxacin is therefore recommended as drug of first choice in the treatment of ocular infections from Pseudomonas aeruginos.