Third- and fourth-generation fluoroquinolones: Retrospective comparison of endophthalmitis after cataract surgery performed over 10 years

被引:70
作者
Jensen, Michael K. [1 ]
Fiscella, Richard G. [4 ,5 ]
Moshirfar, Majid [2 ]
Mooney, Barbara [3 ]
机构
[1] Univ Utah Hosp, Dept Pharm Serv, John A Moran Eye Ctr, Salt Lake City, UT USA
[2] Univ Utah Hosp, Dept Ophthalmol, John A Moran Eye Ctr, Salt Lake City, UT USA
[3] Univ Utah Hosp, Dept Epidemiol, Salt Lake City, UT USA
[4] Univ Chicago, Dept Ophthalmol, Chicago, IL 60637 USA
[5] Univ Chicago, Dept Pharm Practice, Chicago, IL 60637 USA
关键词
D O I
10.1016/j.jcrs.2008.05.045
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE: To determine differences in endophthalmitis rates with prophylactic use of third- versus fourth-gene ration 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, 29 276 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-gene ration fluoroquinolones (ciprofloxacin, ofloxacin) was 0.197% (33/16 710). The rate from September 2003 to December 2007 associated with fourth-gene ration fluoroquinolones (gatifloxacin, moxifloxacin) was 0.056% (7/12 566). The difference between third- and fourth-gene ration drugs was statistically significant (P = .0011). Of fourth-gene ration 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.
引用
收藏
页码:1460 / 1467
页数:8
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