Two Different Concentrations of Topical Levofloxacin for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Keratitis

J Ocul Pharmacol Ther. 2015 Dec;31(10):636-41. doi: 10.1089/jop.2015.0026. Epub 2015 Sep 8.

Abstract

Purpose: To compare the efficacy of topical 1.5% and 0.5% levofloxacin (LVFX) for the treatment of multidrug-resistant Pseudomonas aeruginosa (MDRP) keratitis in rabbits.

Methods: In a rabbit eye, we produced an MDRP keratitis model by excising a 2-mm circular disc of the cornea up to a depth of one-half of the stromal layer and inoculated an MDRP strain into the corneal concavity. Nine hours after inoculation and after confirming that MDRP keratitis had developed, we treated the eyes topically with 0.5% levofloxacin, 1.5% levofloxacin, or phosphate-buffered saline (PBS) every 6 h until 57 h postinfection. The infected eyes were evaluated by clinical score, histopathological examination, and viable bacterial count (colony forming units).

Results: In the MDRP keratitis model, clinical score was significantly lower in 0.5% and 1.5% levofloxacin-treated groups than in PBS-treated group and was the lowest in 1.5% levofloxacin-treated group. Histopathological examination showed maintenance of corneal translucency and little influx of polymorphonuclear neutrophils in 1.5% levofloxacin-treated group. Viable bacterial count in the infected cornea was significantly lower in 0.5% levofloxacin-treated group compared with PBS-treated group, while no viable bacteria were detected in 1.5% levofloxacin-treated group.

Conclusions: Using our MDRP keratitis model, we showed that topical 0.5% levofloxacin is not adequately effective, while 1.5% levofloxacin is efficacious in controlling MDRP keratitis.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Ophthalmic
  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / pharmacology*
  • Colony Count, Microbial
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Drug Resistance, Multiple, Bacterial
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology
  • Keratitis / drug therapy*
  • Keratitis / microbiology
  • Levofloxacin / administration & dosage
  • Levofloxacin / pharmacology*
  • Male
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects
  • Rabbits

Substances

  • Anti-Bacterial Agents
  • Levofloxacin