Navegando por Palavras-chave "Antibiotic prophylaxis"
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- ItemAcesso aberto (Open Access)Aqueous humor concentrations of topical fluoroquinolones alone or in combination with a steroid(Consel Brasil Oftalmologia, 2017) Rodrigues Gomes, Rachel Lopes [UNIFESP]; Viana, Rodrigo Galvao; Soares Melo, Luiz Alberto, Jr. [UNIFESP]; Cruz, Alessandro Carvalho [UNIFESP]; de Souza Lima Filho, Acacio Alves [UNIFESP]; Suenaga, Eunice Mayumi [UNIFESP]; Campos, Mauro [UNIFESP]Purpose: To compare the aqueous humor (AH) concentrations of moxifloxacin 0.5% and gatifloxacin 0.3% solutions alone or when treatment was combined with steroids, and to correlate these concentrations with the minimum inhibitory concentrations (MIC) for the most common endophthalmitis-causing organisms. Methods: Patients undergoing phacoemulsification were enrolled to receive one drop of one of the following solutions: moxifloxacin (G1), moxifloxacin + dexamethasone (G2), gatifloxacin (G3), or gatifloxacin + c (G4), every 15 min, 1h before surgery. AH samples were collected before surgery and analyzed using HPLC-tandem mass spectrometry. Results: The mean antibiotic concentrations in the AH were: G1= 1280.8 ng/mL, G2= 1644.3 ng/mL, G3= 433.7 ng/mL and G4= 308.1 ng/mL. The mean concentrations statistically differed between G1 and G2 (p=0.01), and G3 and G4 (p=0.008). All samples achieved the MIC for Staphylococcus epidermidis 100% of the samples from G1 and G2, and 97% from G3 and G4 reached the MIC for fluoroquinolone-sensitive Staphylococcus aureus 100% of the samples from G1 and G2, 88% from G3, and 72% from G4 reached the MIC for enterococci (p<0.001) and 100% of samples from G1 and G2, 59% from G3, and 36% from G4 reached the MIC for Streptococcus pneumoniae (p<0.001). For fluoroquinolone-resistant S. aureus, 23% from G1, 44% from G2, and no samples from G3 or G4 achieved the MIC (p<0.001). Conclusions: Moxifloxacin + dexamethasone demonstrated a higher concentration in the AH than the moxifloxacin alone. Gatifloxacin + steroids demonstrated less penetration into the anterior chamber than gatifloxacin alone. Moxifloxacin was superior to gatifloxacin considering the MIC for enterococci, S. pneumoniae, and fluoroquinolone-resistant S. aureus.
- ItemAcesso aberto (Open Access)Eficácia de um regime de administração de antibióticos tópicos na redução da microbiota conjuntival de pacientes sadios com catarata senil(Sociedade Brasileira de Oftalmologia, 2007-08-01) Oliveira, Renato Corrêa Souza De [UNIFESP]; Brasil, Oswaldo Ferreira Moura [UNIFESP]; Arantes, Rodrigo Setúbal; Caldas, Leomar Afonso Da Silva; Ferreira, Adriana Lucia Íris; Moraes Junior, Haroldo Vieira De [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Instituto Brasileiro de Oftalmologia Médico do Setor de Retina e Vítreo; Universidade Federal do Rio de Janeiro; Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho Laboratório de Bacteriologia ClínicaPURPOSE: To evaluate the conjunctival bacterial flora of healthy patients and its antibiotic resistance pattern and determine the effective of a regime of topical antibiotics on reduction of endogenous microbiota. METHODS: Its a prospective non randomized study. Fourty eyes of 40 patients, divided in 4 groups of 10 eyes each, used four differents topical antibiotics (ciprofloxacin, tobramycin and gatifloxacin). One group served as a control group. Were performed conjunctival cultures before instillation of the antibiotics drops and after 15, 30 and 60 minutes. Were performed susceptibility tests of the specimes isolated to these antibiotics. We compared the reduction of bacterium growth by assessing the number of UFC (colonies forming units) before and after the instillation of antibiotics drops. RESULTS: Of the 40 eyes, 92,5% had positive cultures. The coagulase-negative Staphylococcus (CNS) was the most frequent organism isolated (50%), followed by Staphylococcus Aureus (23%) and gram-negative bacteria (26%). More than 81% of the isolates of this bacterium were susceptible to all antibiotics tested. Five bacterium isolates were resistant to ciprofloxacin and tobramycin and two to gatifloxacin. All groups had diminished the number of patients with positive culture specimes from the conjuntiva compared to moment zero and to placebo. CONCLUSION: The gram positive bacterium, specially the coagulase-negative Staphylococcus, were the most frequent microorganism found on conjunctiva of healthy patients. The most of the bacterium isolated were sensitivity to the antibiotics tested. The proposed regime of use of these antibiotics reduced the number of UFC (colonies forming units) compared to placebo although without statics relevance in most of cases.
- ItemAcesso aberto (Open Access)Flora bacteriana conjuntival após uso tópico de ciprofloxacino e gatifloxacino em cirurgia de catarata(Conselho Brasileiro de Oftalmologia, 2008-04-01) Arantes, Tiago Eugênio Faria e [UNIFESP]; Castro, Célia Maria Machado Barbosa de; Cavalcanti, Ronald Fonseca; Severo, Maiara Santos; Diniz, Maria de Fátima Alves; Urtiga, Ricardo Walber de Deus; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco Departamento de Medicina Tropical; Fundação Altino Ventura Departamento de Córnea e Doenças Externas; UFPE Laboratório de Imunopatologia Keizo-Asami; FAVPURPOSE: To evaluate alterations of the conjunctival flora after the use of 0.3% ciprofloxacin and gatifloxacin in the prophylaxis of patients undergoing cataract surgery. METHODS: 40 patients undergoing cataract surgery were distributed into two groups according to the use of antibiotic eye drops: Group A: 0.3% ciprofloxacin and Group B: 0.3% gatifloxacin. Both groups used antibiotic eye drops 1 hour before surgery and 14 days after surgery. Conjunctival material was collected at 5 time points: 1 hour before surgery, without any topical medication (t0); immediately before the application of povidone-iodine (PVPI) (t1), before the beginning of surgery, after povidone-iodine (t2), 14 days (t3) and 28 days after surgery (t4). RESULTS: Preoperative antibiotics reduced the positivity of the cultures before the use of PVPI in both groups, although in Group A this reduction was not significant (Group A - p=0.07 and Group B - p=0.04). The number of positive cultures was reduced in all groups after the use of povidone-iodine and on the 14th postoperative day (p<0.05). In t4 there was a reduction in the frequency of coagulase-negative Staphylococcus in Group A compared with Group B (p<0.05); the susceptibility to ciprofloxacin was also reduced in all groups, when compared with t0. CONCLUSIONS: Gatifloxacin eye drops applied one hour before surgery significantly reduced the number of positive conjunctival cultures. Both antibiotics reduced the conjunctival flora when administered in the postoperative period.
- ItemAcesso aberto (Open Access)Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification(Consel Brasil Oftalmologia, 2017) Vieira, Ibraim Viana [UNIFESP]; Boianovsky, Celso; Saraiva, Thais Jones; de Godoy, Rodolfo Bregion; Lake, JonathanPurpose: To evaluate the safety and efficacy of 0.05 mL intracameral injection of moxifloxacin in patients who underwent phacoemulsification and intraocular lens (IOL) implant. Methods: Retrospective study comprising patients who underwent phacoemulsification and IOL implant between January 2009 and December 2013. Patients were divided into two groups. Group A followed standard endophthalmitis prevention protocol and group B followed the same protocol plus intracameral injection of 0.05 mL of moxifloxacin hydrochloride at 5.45 mg/mL, immediately after IOL implant. Results: Medical records from 7,195 eyes of 3,751 patients (median age: 67.8 +/- 8.96, range: 48-83 years, 53.8% female) were evaluated. Group A included 3,515 eyes of 1,838 patients and group B included 3,680 eyes of 1,913 patients. The incidence of endophthalmitis in group A was 0.22% (8: 3,515 eyes) and in group B was 0.03% (1: 3,680 eyes, p= 0.0198, Fischer's exact test). No toxicity or inflammation related to the use of moxifloxacin was observed. Conclusions: There was a 7.3-fold lower ratio of endophthalmitis in the group that received moxifloxacin intracameral injection. This study provides further evidence that moxifloxacin is an effective intracameral prophylactic antibiotic.