Assessment and Comparison of Microbiological Efficacy of Moxifloxacin plus Vancomycin Combined Therapy with Fortified Vancomycin in Bacterial Conjunctivitis
Background: Bacterial Conjunctivitis or red eye being highly communicable need to be tackle at the earliest. Newer antibiotics may kill bacteria more rapidly. Thus, we aim to assess and compare microbiological efficacy of Moxifloxacin (0.5%) plus Vancomycin (2.5%) combined therapy to Fortified Vancomycin (5%) in relation to organism isolated in positive culture of bacterial conjunctivitis. Methods: The present study was conducted on patients who presented at Ophthalmology OPD, Jawaharlal Nehru Medical College Hospital, Aligarh and Gandhi Eye Hospital, Aligarh. The patients with bilateral conjunctivitis were included in the study. Right eyes were instilled moxifloxacin plus vancomycin combination therapy and Left eyes were instilled fortified vancomycin. Microbiological outcomes were recorded on first visit and on follow up visits during course of treatment.
Results: A total of 35 patients were included in the study. At first visit, 14 cases were positive with coagulase negative Staphylococcus (CoNS) being the most common organisms. All the positive smears became negative in first follow-up (3rd day) in both the groups. No significant difference was found in microbiological study outcome between the two-study groups.
Conclusions: We conclude that both the drugs, i.e. moxifloxacin (0.5%) plus vancomycin (2.5%) combined therapy and fortified vancomycin (5%) had good efficiency in microbial elimination in cases of bacterial conjunctivitis with equivalent outcome and can be considered as an alternative to other antimicrobial therapy in bacterial conjunctivitis.
2. Bartlett JD, Jaanus S. Clinical Ocular Pharmacology. St. Louis, MO: Butterworth Heinemann Elsevier; 2008.
3. Cavuoto K, Zutshi D, Karp CL, et al. Update on bacterial conjunctivitis in South Florida. Ophthalmology. 2008; 115(1):51–56.
4. Wilhelmus KR, Hyndiuk RA, Caldwell DR, et al. 0.3% Ciprofloxacin ophthalmic ointment in the treatment of bacterial keratitis. Arch Ophthalmol. 1993;111:1210–8.
5. Daniel F Goodman, John D gottsch. Methicillin resistant Staphylococcus epidermidis keratitis treated with vancomycin. Arch ophthalmol. 1988;106:1570-2.
6. Eguchi H, Shiota H, Oguro S, et al. The inhibitory effect of vancomycin ointment on the manifestation of methicillin resistant Staphylococcal keratitis in rabbits. J infect Chemother. 2009;15:279:283.
7. Lichtenstein SJ, Wagner RS, Jamison T, et al. Speed of bacterial kill with a fluoroquinolone compared with nonfluoroquinolones: clinical implications and a review of kinetics of kill studies. Adv Ther. 2007;24(5):1098–1111.
8. Ohnsman C, Ritterband D, O’Brien T, et al. Comparison of azithromycin and moxifloxacin against bacterial isolates causing conjunctivitis. Curr Med Res Opin. 2007;23(9):2241–2249.
9. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. [Internet]. 2011 [cited 2018 May 21]. Available from: https://www.ibm.com/products/spss-statistics
10. Gangopadhyay N, Daniell M, Weih L, Taylor HR. Fluoroquinolone and fortified antibiotics for treating bacterial corneal ulcers. British journal of ophthalmology. 2000 Apr 1;84(4):378-84.