Treatment of rabbit corneal infections with ophthalmic gatifloxacin: a concentration dependence study

This study was designed to determine the most effective dose of gatifloxacin in ophthalmic solution for control of methicillin-resistant Staphylococcus aureus (MRSA) corneal infections in rabbits. Rabbits were inoculated by injecting 9300 colony-forming units of MRSA into the corneal stroma of the eye (n=43). They were then randomly assigned to topical administration of saline, ofloxacin 0.3%, or gatifloxacin 0.02%, 0.1%, 0.3%, or 0.5% ophthalmic solutions. Infection severity 48 hours postinoculation was assessed by masked observers using standard scales. After treatment completion, viable MRSA in corneal tissue were counted, and pathologic examinations of ocular tissues were conducted. Relative to saline, treatment with gatifloxacin 0.3% or 0.5% decreased mean infection scores at every time point from 16 to 48 hours after inoculation (P < or = .012) and reduced area-under-the-curve values for infection scores by 50.3% and 54.2%, respectively (P = .00005). Rabbits treated with gatifloxacin 0.3% and 0.5% had lower area-under-the-curve values than those treated with ofloxacin 0.3% (P < or = .039). Viable MRSA in corneal tissue after gatifloxacin 0.3% or 0.5% treatment were decreased to less than 1% of those found after ofloxacin 0.3% treatment. Gram-positive colony formation and abscesses found in saline-treated corneas were distinctly alleviated by treatment with gatifloxacin 0.3% or 0.5%. No significant differences were observed between treatments with gatifloxacin 0.3% or 0.5% ophthalmic formulations and they were equally effective. Topical administration of gatifloxacin 0.3% or 0.5% ophthalmic solutions controlled MRSA corneal infections in rabbits significantly better than saline or ofloxacin 0.3%.