Prospective randomized comparison of 1-day versus 3-day application of topical levofloxacin in eliminating conjunctival flora

• Published in: European journal of ophthalmology 2007-09, Vol.17 (5), p.689-695
• Main Authors: Ta, C N, Sinnar, S, He, L, Myung, D, Miño De Kaspar, H
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - administration & dosage; Conjunctiva - microbiology; Endophthalmitis - drug therapy; Endophthalmitis - microbiology; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - microbiology; Follow-Up Studies; Gram-Positive Bacteria - drug effects; Gram-Positive Bacteria - isolation & purification; Gram-Positive Bacterial Infections - drug therapy; Gram-Positive Bacterial Infections - microbiology; Humans; Levofloxacin; Middle Aged; Ofloxacin - administration & dosage; Ophthalmic Solutions; Prospective Studies; Treatment Outcome
• ISSN: 1120-6721; 1724-6016
• DOI: 10.1177/112067210701700501

To compare efficacy of a 1-day versus 3-day application of topical levofloxacin in reducing ocular surface bacteria. In this prospective randomized controlled trial, 100 volunteer patients (50 per group) were assigned to receive topical 0.5% levofloxacin four times daily for 1 day or 3 days. Conjunctival cultures were obtained prior to (T0) and after the application of antibiotics (T1). Additionally, all patients received topical levofloxacin at 5-minute intervals for three applications (T2), followed by two drops of topical 5% povidone-iodine (T3). Conjunctival cultures were obtained at timepoints T2 and T3. A 1-day application of topical levofloxacin significantly reduced (p = 0.0004) the number of eyes with positive conjunctival cultures from 41 eyes (82%) to 23 eyes (46%). Similarly, a 3-day application significantly reduced (p = 0.0001) the positive culture rate from 37 eyes (74%) to 17 eyes (34%). Two drops of povidone-iodine further reduced the positive culture rate for both groups to 20% (10 eyes for each group). There was no significant difference in positive culture rate between the 1-day and 3-day groups at T0 (p = 0.4689), T1 (p = 0.3074), T2 (p = 0.6706), or T3 (p = 1.000). The application of topical 0.5% levofloxacin for 1 or 3 days significantly reduced the number of eyes with positive conjunctival cultures. The addition of 5% povidone-iodine further eliminated bacteria from the conjunctiva. The application of levofloxacin for 1 day appears to be as effective as a 3-day application.