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    Resistance to fluoroquinolones impacts retina cases

    Staphylococcus epidermidis repeatedly exposed to antibiotics rapidly develop resistance

     

    Multidrug resistance

    Results from 77 Staphylococcus epidermidis cultured from fluoroquinolone-treated eyes during the study showed an increased resistance to fluoroquinolones, but also co-resistance,3 Dr. Kim said.

    “Co-resistance was a common pattern, with increasing resistance to Bactrim, 27% in the treated eye vs. 10% in the control eyes,” Dr. Kim explained. “You see increased resistance to clindamycin, 18% vs. 6% in the control eyes. Also, increasing resistance to gentamicin, 8% vs. 1% in the control eyes, was observed. This co-resistance to antibiotics occurred despite no obvious cross-mechanism of action.”

    Over the course of the study, up to 25% of control eyes were still pansensitive. However, in the eyes that were treated with antibiotics, only 3% remained pansensitive, and “an alarming amount of these strains were multi-resistant to 8, 9, or 10 antibiotics,” Dr. Kim said.

     

    References:

    1. Bhavsar AR, Googe JM, Stockdale CR, eta al. Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required: the diabetic retinopathy clinical research network laser-ranibizumab-triamcinolone clinical trials. Arch Ophthalmol. 2009; 127:1581-3.

    2. Kim SJ, Toma HS. Ophthalmic antibiotics and antimicrobial resistance a randomized, controlled study of patients undergoing intravitreal injections. Ophthalmology. 2011;118(7):1358-63.

    3. Dave SB, Toma HS, Kim SJ. Ophthalmic antibiotic use and multidrug-resistant staphylococcus epidermidis: a controlled, longitudinal study. Ophthalmology. 2011;118:2035-40.

     

    Stephen Kim, MD

    E: [email protected].

    This article was adapted from a presentation that Dr. Kim presented at the 2016 American Academy of Ophthalmology meeting. He has no financial disclosures to declare relevant to this topic.

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