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Multistrain comparison of three antimicrobial prophylaxis regimens in experimental postoperative Pseudomonas
Abstract:
We compared subconjunctivally administered ceftazidime and BMY 28142, two third-generation cephalosporins, to a regimen of gentamicin and cefazolin for their ability to prevent experimental Pseudomonas postoperative endophthalmitis in rabbits. After extracapsular lens extraction, an inoculum of Pseudomonas was injected into the vitreous; one of the three antimicrobial regimens was then administered subconjunctivally. All 25 eyes treated with gentamicin and cefazolin become infected (P = 1). Two of 25 eyes treated with BMY 28142 became infected (P less than .001). None of the 25 eyes treated with ceftazidime became infected (P less than .001).
Insights
Ceftazidime, a third-generation cephalosporin, completely prevented Pseudomonas postoperative endophthalmitis in rabbits. This antibiotic showed superior efficacy compared to gentamicin/cefazolin and BMY 28142 in preventing ocular infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pharmacology
Background:
- Postoperative endophthalmitis is a severe ocular infection.
- Pseudomonas aeruginosa is a common cause of postoperative endophthalmitis.
- Effective antimicrobial prophylaxis is crucial for preventing endophthalmitis.
Purpose of the Study:
- To compare the efficacy of subconjunctival ceftazidime and BMY 28142 against a gentamicin/cefazolin regimen.
- To evaluate the preventative capabilities of these antibiotics against experimental Pseudomonas endophthalmitis in rabbits.
Main Methods:
- Rabbits underwent extracapsular lens extraction.
- Intravitreal injection of Pseudomonas aeruginosa was performed.
- Subconjunctival administration of one of three antimicrobial regimens: ceftazidime, BMY 28142, or gentamicin/cefazolin.
Main Results:
- None of the 25 eyes treated with ceftazidime became infected (P < .001).
- Two of 25 eyes treated with BMY 28142 became infected (P < .001).
- All 25 eyes treated with gentamicin and cefazolin became infected (P = 1).
Conclusions:
- Subconjunctival ceftazidime demonstrated complete efficacy in preventing experimental Pseudomonas endophthalmitis.
- Ceftazidime is a highly effective prophylactic agent for preventing postoperative endophthalmitis caused by Pseudomonas.
- BMY 28142 showed some efficacy, while gentamicin/cefazolin was ineffective in this model.