Document Detail


Third- and fourth-generation fluoroquinolones: retrospective comparison of endophthalmitis after cataract surgery performed over 10 years.
MedLine Citation:
PMID:  18721704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine differences in endophthalmitis rates with prophylactic use of third- versus fourth-generation fluoroquinolones in cataract surgery.
SETTING: University hospitals.
METHODS: This retrospective cross-sectional (prevalence) study looked at patients who had phacoemulsification at a university eye center over a 10-year period. A nosocomial infectious reporting database was used to report endophthalmitis occurrences. The following were performed: a retrospective analysis of prospectively collected data to establish endophthalmitis rates, a prevalence analysis of the postoperative quinolone antibiotic prescribed, and a comparative analysis of endophthalmitis rate versus postoperative quinolone prescribed for all reported endophthalmitis cases. The main outcome measure was occurrence of endophthalmitis after cataract surgery.
RESULTS: From January 1997 to December 2007, 29276 patients had phacoemulsification cataract surgery. Forty cases of postoperative bacterial endophthalmitis were reported. The endophthalmitis rate from January 1997 to August 2003 associated with use of third-generation fluoroquinolones (ciprofloxacin, ofloxacin) was 0.197% (33/16710). The rate from September 2003 to December 2007 associated with fourth-generation fluoroquinolones (gatifloxacin, moxifloxacin) was 0.056% (7/12566). The difference between third- and fourth-generation drugs was statistically significant (P = .0011). Of fourth-generation fluoroquinolone infections, 0.015% (1/6651) and 0.1% (6/5915) were associated with gatifloxacin and moxifloxacin, respectively. The difference between drugs was statistically significant (P = .040).
CONCLUSIONS: The differences in the pharmacokinetic and pharmacodynamic properties of quinolone antibiotics may affect the endophthalmitis incidence after cataract surgery. The significant difference in endophthalmitis rates between gatifloxacin and moxifloxacin requires further study.
Authors:
Michael K Jensen; Richard G Fiscella; Majid Moshirfar; Barbara Mooney
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  34     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-25     Completed Date:  2008-10-03     Revised Date:  2013-04-24    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1460-7     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Services, Moran Eye Center, University of Utah Hospital, 65 North Medical Drive, Salt Lake City, UT 84132, USA. mike.jensen@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anti-Infective Agents / therapeutic use*
Antibiotic Prophylaxis*
Aza Compounds / therapeutic use
Ciprofloxacin / therapeutic use
Cross-Sectional Studies
Endophthalmitis / epidemiology*,  prevention & control
Eye Infections, Bacterial / epidemiology*,  prevention & control
Female
Fluoroquinolones / therapeutic use
Humans
Male
Middle Aged
Ofloxacin / therapeutic use
Phacoemulsification*
Postoperative Complications*
Prevalence
Quinolines / therapeutic use
Retrospective Studies
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 0/Aza Compounds; 0/Fluoroquinolones; 0/Quinolines; 82419-36-1/Ofloxacin; 85721-33-1/Ciprofloxacin; L4618BD7KJ/gatifloxacin; U188XYD42P/moxifloxacin
Comments/Corrections
Comment In:
J Cataract Refract Surg. 2009 Feb;35(2):206; author reply 207-9   [PMID:  19185216 ]
J Cataract Refract Surg. 2009 Feb;35(2):206-7; author reply 207-9   [PMID:  19185215 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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