Date Posted: 04 May 2010
New research from the Department of Ophthalmology and Medical Microbiology at Royal Liverpool University Hospital has reported on the susceptibility of 722 bacterial isolates from patients who presented with suppurative keratitis. The data revealed that Meropenem, a newer anti-microbial potentially suitable for ophthalmic use, may represent the best choice for empiric monotherapy in bacterial keratitis.
The research, reported by Dr. Henry Sueke and colleagues at the University of Liverpool, showed that resistance was present to several commonly used antimicrobials in each of five bacterial groups assessed. The research reported that approximately 80% of S. aureus, 87% of streptococci and 96% of coagulase negative staphylococci were susceptible to ciprofloxacin and that two isolates of S. aureus were identified that were moxifloxacin resistant, one of which was methicillin resistant. The numbers reported reflect a clinical concern of potentially increased resistance to certain antimicrobials in the UK's population. The overall data suggested that, of the fluroquinolones in regular use, moxifloxacin had the best kill rate against both Gram positive- and negative- isolates, a finding consistent with previous studies.
Bacterial keratitis is a serious ocular disorder with an incidence among contact lens wearers that is six times higher than the general population. Prompt and effective treatment is critical in managing the disease and as resistance to antimicrobial drugs may be increasing there is a clear clinical need to evaluate new drugs. Meropenem is one such drug currently approved by the FDA for the treatment of skin infections, abdominal infections and bacterial meningitis. Recent studies have shown the drug to be as safe as ceftazidime when delivered intravitreally in animal models. Originally developed by Sumitomo Pharmaceuticals the drug is a beta lactam (belonging to the subgroup of carbapenem) and represents a very broad spectrum injectable antibiotic currently marketed outside of Japan by Astra Zeneca. The research report was published in the journal Investigative Ophthalmology and Visual Science, May 2010, Vol. 51, No. 5, pp2519-2523.
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