Related Experiment Videos
Comparative intravitreal antibiotic therapy for experimental Enterococcus faecalis endophthalmitis
S Choi1, T W Hahn, G Osterhout
1Ocular Microbiology Laboratory, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|January 1, 1996
Summary
Intravitreal vancomycin plus amikacin effectively treats vancomycin-sensitive Enterococcus faecalis endophthalmitis. Intravitreal ampicillin plus gentamicin is effective for vancomycin-resistant strains, offering crucial insights for treating this severe eye infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endophthalmitis, a severe intraocular infection, can be caused by Enterococcus faecalis.
- Vancomycin resistance in E. faecalis presents a significant therapeutic challenge.
- Effective intravitreal antibiotic strategies are crucial for preserving vision.
Purpose of the Study:
- To determine the most effective intravitreal antibiotic treatments for experimental vancomycin-sensitive and vancomycin-resistant Enterococcus faecalis endophthalmitis.
- To compare the efficacy of various antibiotic combinations administered intravitreally.
Main Methods:
- An experimental animal model using New Zealand white rabbits was established.
- Intravitreal injections of vancomycin-sensitive or -resistant E. faecalis were administered.
- Rabbits received various intravitreal antibiotic treatments, including vancomycin, amikacin, gentamicin, ceftazidime, ampicillin, and pristinamycin, or were assigned to control groups.
- Vitreous humor was collected 24 hours post-treatment for quantitative bacteriological analysis.
Main Results:
- For vancomycin-sensitive E. faecalis, combined vancomycin and amikacin demonstrated the most significant reduction in bacterial load.
- In the vancomycin-resistant E. faecalis model, combined ampicillin and gentamicin therapy was most effective, followed by combined vancomycin and amikacin.
- Statistical analysis (Wilcoxon's rank sum test) confirmed the significance of these findings (P < .01).
Conclusions:
- Intravitreal vancomycin plus amikacin provides effective bactericidal therapy for experimental vancomycin-sensitive E. faecalis endophthalmitis.
- Intravitreal ampicillin plus gentamicin is an effective treatment for experimental vancomycin-resistant E. faecalis endophthalmitis.
- These findings support specific combination therapies for different vancomycin susceptibility profiles of E. faecalis endophthalmitis.