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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.



    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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