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    Resistance to fluoroquinolones impacts retina cases

    Staphylococcus epidermidis repeatedly exposed to antibiotics rapidly develop resistance

     

    ARCaNE findings

    Enrolled subjects (N = 24) were all assigned and mandated to receive 4 consecutive injections (on a monthly dosing regimen). Subjects were treated as needed for 1 year, and randomized to 1 of 4 antibiotics (azithromycin, gatifloxacin, moxifloxacin, and ofloxacin). Each subject used the antibiotic for 3 days after each intravitreal injection.

    Bilateral conjunctival cultures were taken at baseline and after each injection of both the treated eye and the fellow control eye (the untreated eye). Nasopharyngeal cultures also were taken on the treatment side at baseline and following each injection after exposure to antibiotics.

    The 4 mandatory injections translated to a minimum of 5 culture results per subject, but the patients could have as many as 13 cultures if they were treated monthly for the full year of the study.

    “This is really critical as the study was prospective and longitudinal and was able to establish cause and effect,” Dr. Kim said.

    “We didn't pick up any Streptococcus pneumoniae from the nasopharynx, but 8 of the 24 patients tested positive for S. aureus,” Dr. Kim said. “The baseline antibiotic resistance of these 8 S. aureus demonstrated substantial resistance to macrolides (erythromycin and azithromycin), but minimal resistance to other antibiotic groups.” (See above table.)

    Resistant strain emerges

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