Clinical Analysis of the 0.3% Tosufloxacin Ophthalmic Solution Effect on Conjunctival Normal Flora

Young Ki Kwon; Kun Wook Kang; Hong Kyun Kim

doi:10.3341/jkos.2015.56.2.199

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Kwon, Kang, and Kim: Clinical Analysis of the 0.3% Tosufloxacin Ophthalmic Solution Effect on Conjunctival Normal Flora

Original Article

J Korean Ophthalmol Soc 2015;56(2):199-204.

Published online: 6 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.2.199

Clinical Analysis of the 0.3% Tosufloxacin Ophthalmic Solution Effect on Conjunctival Normal Flora

Young Ki Kwon, MD, Kun Wook Kang, MD, Hong Kyun Kim, MD, PhD

Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea

Address reprint requests to Hong Kyun Kim, MD, PhD, Department of Ophthalmology, Kyungpook National University Hospital, #130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea, Tel: 82-53-200-5816, Fax: 82-53-426-6552 E-mail: okeye@hanmail.net

Received 5 April 201424 December 2014 Accepted 28 January 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the outcomes of clinical analysis on the negative culture rate of normal ocular surface flora and the anterior chamber penetration after the preoperative prophylactic use of 0.3% tosufloxacin ophthalmic solution.

Methods

From July 2010 to June 2012, 38 eyes of 38 patients who were scheduled to receive intravitreal injection or cataract surgery were examined for bacterial culture positive rate using conjunctival scraping. The patients were treated with 0.3% tosufloxacin eyedrops preoperatively 5 times a day for 2 days before surgery. After the treatment, the bacterial culture negative rate based on conjunctival scraping was assessed to evaluate the drug efficacy. Of the 38 patients, 19 had cataract surgery. The con-centration of tosufloxacin at anterior chamber was assessed in the 19 patients. Additionally, any side effects from the drug were monitored during the treatment.

Results

Among the 38 eyes, 21 eyes showed a bacterial culture positive rate before treatment. After the drug treatment, the bacterial culture negative rate was 57.1% (12/21). Coagulase-negative staphylococci were most frequently cultured in 15 (39%) of the 38 eyes before treatment and the negative rate of bacterial culture was 86.7% (13/15) after treatment. Average antibiotic residue concentrations in aqueous humor was 0.050 ± 0.038 μ g/mL. No side effects from the drug were reported during the experimental period.

Conclusions

Although the 0.3% tosufloxacin eyedrops were not effective in all bacterial strains and showed relatively low pene-tration rate into the anterior chamber, they were effective in some gram positive organisms, particularly in coagulase-negative staphylococci of normal ocular surface flora.

Keywords: Antibiotic prophylaxis, Endopthalmitis, Prevention, Tosufloxacin

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Figure 1.

MIC 50 and MIC 90 concentration of Tosufloxacin for each bacterial isolates (bold line is the level of residual con-centration of tosufloxacin measured in anterior chamber). MIC = minimum inhibitory concentration.

Table 1.

Bacteriological efficacy (sterilization rate)

Microorganism	Eradicated	Persistence	Unable to determine	Sterilization rate
Coagulase negative staphylococcus	13	2	2	86.7
α-hemolytic streptococcus	0	0	1	N/A
S.aureus	1	1	1	50
Bacilllus sp.	1	1	0	50
Enterococcus faecium	1	0	0	100
Enterobacter sp.	1	0	1	100

Eradicated: No detection of causative microorganism; Persistence: Apparent reduction in causative microorganism cannot be demonstrated; Unable to determine: Causative microorganism cannot be confirmed.

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