Topical ophthalmic moxifloxacin elicits minimal or no selection of fluoroquinolone resistance among bacteria isolated from the skin, nose, and throat

J Pediatr Ophthalmol Strabismus. 2012 Mar-Apr;49(2):88-97. doi: 10.3928/01913913-20111101-02. Epub 2011 Nov 8.

Abstract

Purpose: To investigate whether moxifloxacin therapy of bacterial conjunctivitis in children changes the moxifloxacin susceptibility of bacterial isolates in eyes, cheeks below eyes, nares, and throat.

Methods: Patients (age: 1 to 12 years, n = 105) with bacterial conjunctivitis were treated topically with moxifloxacin three times a day for 7 days. Gender- and age-matched subjects with normal eyes (age: 1 to 12 years, n = 57) served as the control group. Microbiological specimens were collected on days 1 (prior to therapy), 8 (1 day after end of therapy), and 42 (follow-up). Specimens were processed to recover total bacteria and bacteria that grew on fluoroquinolone-selective media. Bacteria were identified to the species level and susceptibility to moxifloxacin and selected other antibiotics determined.

Results: The primary pathogens recovered from the infected eyes on day 1 before therapy were Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus. None of the pre-therapy isolates of H. influenzae and S. pneumoniae were resistant to moxifloxacin. Isolates of these two pathogenic species were also recovered primarily from the nose and eyes. Moxifloxacin-resistant S. aureus isolates (minimum inhibitory concentration 1.0 μg/mL or greater) were recovered from the nose and throat prior to topical dosing on day 1. However, there was no change in the frequency of moxifloxacin-resistant isolates of S. aureus following treatment with moxifloxacin.

Conclusion: Treatment of conjunctivitis with topical ophthalmic moxifloxacin did not select for moxifloxacin resistance in H. influenzae, S. pneumoniae, or S. aureus in the eye or distal body sites.

MeSH terms

  • Administration, Topical
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Aza Compounds / administration & dosage
  • Aza Compounds / therapeutic use*
  • Bacteria / drug effects*
  • Bacteria / isolation & purification
  • Child
  • Child, Preschool
  • Conjunctivitis, Bacterial / drug therapy*
  • Conjunctivitis, Bacterial / microbiology
  • Drug Resistance, Bacterial*
  • Female
  • Fluoroquinolones
  • Haemophilus influenzae / drug effects
  • Haemophilus influenzae / isolation & purification
  • Humans
  • Infant
  • Male
  • Microbial Sensitivity Tests
  • Moxifloxacin
  • Nasal Mucosa / microbiology*
  • Ophthalmic Solutions
  • Pharynx / microbiology*
  • Quinolines / administration & dosage
  • Quinolines / therapeutic use*
  • Skin / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Ophthalmic Solutions
  • Quinolines
  • Moxifloxacin