Efikasnost primene moksifloksacina kod bolesnika sa bakterijskim keratitisom
Sažetak
Uvod/Cilj. Keratitisi su sociomedicinski problem srednje razvijenih zemalja u koje spada i Srbija. U odnosu na sve keratitise, učestalost bakterijskih keratitisa u svetu je oko 20%, a u Srbiji je još nepoznate učestalosti. Imajući u vidu komplikacije na prednjem segmentu oka nakon bakterijskog keratitisa (ulkus, neovaskularizacijа, fibrozа) i pad oštrine vida, bilo je potrebno proceniti efikasnost lokalne terapije moksifloksacinom, koja će skratiti vreme izlečenja i redukovati komplikacije. Cilj rada bio je analiza efikasnosti lečenja bakterijskih keratitisa moksifloksacinom. Metode. Studija je osmišljena kao prospektivna, randomizovana, dvostruko slepa klinička studija. Ona je obuhvatila 30 bolesnika sa dijagnostikovanim keratitisom i lokalno aplikovanim antibiotikom moksifloksacinom i 60 ispitanika kontrolne grupe, sa lokalno aplikovanim veštačkim suzama. Ispitanici su podvrgnuti kompletnoj oftalmološkoj analizi tokom 2015/16. godine u planiranom periodu od 1. do 15. dana od primene terapija (vreme sanacije kornealne patologije). Kod svih ispitanika određivan je stepen hiperemije, težina kornealnog defekta, kornealni senzitivitet, količina suza i kvalitet suznog filma, konjunktivalna sekrecija, neovaskularizacija i ožiljne formacije rožnjače, funkcionalna oštrina vida, skor subjektivne simptomatologije i korelacije oftalmološkog kliničkog nalaza i subjektivnih simptoma. Rezultati. Utvrđena je statistički značajna razlika u pogledu terapijske efikasnosti/kliničkog odgovora između studijske grupe, koja je primala moksifloksacin i kontrolne grupe, koja je primala placebo. Zaključak. Lokalna primena moksifloksacina je ostvarila terapijsku efektivnost (ukupan terapijski benefit), kako u domenu efikasnog skraćenja vremena izlečenja, tako i u redukciji komplikacija keratitisa, bez neželjenih dejstava.
Reference
REFERENCES
Al-Mujaini A, Al-Kharusi N, Wali UK. Bacterial Keratitis: Perspective on Epidemiology, Clinic-Pathogenesis, Diagnosis and Treatment. Sultan Qaboos Univ Med J 2009; 9(2): 184–95.
Chikviladze D, Nikuradze N, Gachechiladze K, Miqeladze M, Metreveli D. Microbial structure of acute bacterial conjunctivitis. Georgian Med News 2013; 216: 12−5. (Russian)
Green M, Apel A, Stapleton F. Risk factors and causative organ-isms in microbial keratitis. Cornea 2008; 27(1): 22−7.
Schaefer F, Bruttin O, Zografos L, Guex-Crosier Y. Bacterial keratitis: A prospective clinical and microbiological study. Br J Ophthalmol 2001; 85(7): 842−7.
Vajpayee RB, Dada T, Saxena R, Vajpayee M, Taylor HR, Venkatesh P, et al. Study of the first contact management profile of cases of infectious keratitis: A hospital-based study. Cornea 2000; 19(1): 52−6.
Pawar P, Katara R, Mishra S, Majumdar DK. Topical ocular delivery of fluoroquinolones. Expert Opin Drug Deliv 2013; 10(5): 691−711.
Vignesh AP, Srinivasan R, Karanth S. A Case Report of Severe Corneal Toxicity following 0.5% Topical Moxifloxacin Use. Case Rep Ophthalmol 2015; 6(1): 63−5.
Benitez-del-Castillo J, Verboven Y, Stroman D, Kodjikian L. The role of topical moxifloxacin, a new antibacterial in Europe, in the treatment of bacterial conjunctivitis. Clin Drug Investig 2011; 31(8): 543−57.
Schlech BA, Alfonso E. Overview of the potency of moxiflox-acin ophthalmic solution O. 5% (VIGAMOX). Surv Oph-thalmol 2005; 50(Suppl 1): S7−15.
Labbé A, Liang Q, Wang Z, Zhang Y, Xu L, Baudouin C, et al. Corneal nerve structure and function in patients with non-sjogren dry eye: Clinical correlations. Invest Ophthalmol Vis Sci 2013; 54(8): 5144−50.
Toker E, Asfuroğlu E. Corneal and conjunctival sensitivity in patients with dry eye: The effect of topical cyclosporine therapy. Cornea 2010; 29(2): 133−40.
Moore PA. Diagnosis and management of chronic corneal epi-thelial defects (indolent corneal ulcerations). Clin Tech Small Anim Pract 2003; 18(3): 168−77.
Goldberg HL. Clinical assessment, diagnosis, and management of the cornea. Can Fam Physician 1990; 36(4): 741−3.
Kikkawa Y. Normal corneal staining with fluorescein. Exp Eye Res 1972; 14(1): 13−20.
Bandamwar KL, Papas EB, Garrett Q. Fluorescein staining and physiological state of corneal epithelial cells. Cont Lens Ante-rior Eye 2014; 37(3): 213−23.
Ward KW. Superficial punctate fluorescein staining of the ocular surface. Optom Vis Sci 2008; 85(1): 8−16.
Feenstra RP, Tseng SC. Comparison of fluorescein and rose bengal staining. Ophthalmology 1992; 99(4): 605−17.
Wilson G, Ren H, Laurent J. Corneal epithelial fluorescein staining. J Am Optom Assoc 1995; 66(7): 435−41.
Miyata K, Amano S, Sawa M, Nishida T. A novel grading me-thod for superficial punctate keratopathy magnitude and its correlation with corneal epithelial permeability. Arch Oph-thalmol 2003; 121(11): 1537−9.
Himebaugh NL, Nam J, Bradley A, Liu H, Thibos LN, Begley CG. Scale and spatial distribution of optical aberrations associated with tear break-up. Optom Vis Sci 2012; 89(11): 1590−600.
Begley CG, Himebaugh N, Renner D, Liu H, Chalmers RL, Simpson T, et al. Tear breakup dynamics: A technique for quantifying tear film instability. Optom Vis Sci 2006; 83(1): 15−21.
Romanchuk KG. Enhanced models for teaching slit-lamp skills. Can J Ophthalmol 2003; 38(6): 507−11.
Cutler TJ. Corneal epithelial disease. Vet Clin North Am Equine Pract 2004; 20(2): 319−43, vi.
Himebaugh NL, Begley CG, Bradley A, Wilkinson JA. Blinking and tear break-up during four visual tasks. Optom Vis Sci 2009; 86(2): E106−14.
Macri A, Pflugfelder S. Correlation of the Schirmer 1 and fluo-rescein clearance tests with the severity of corneal epithelial and eyelid disease. Arch Ophthalmol 2000; 118(12): 1632−8.
Pflugfelder SC, Tseng SC, Sanabria O, Kell H, Garcia CG, Felix C, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea 1998; 17(1): 38− 56.
Mapstone R. Anterior segment ischaemia and hyperaemia. Trans Ophthalmol Soc U K 1970; 90: 329−35.
Blagojevic M. Importance of conjunctival and ciliary hyperemia in diagnosis of eye diseases. Med Glas 1958; 12(1): 3−6. (Ser-bian)
Fintelmann RE, Hoskins EN, Lietman TM, Keenan JD, Gaynor BD, Cevallos V, et al. Topical fluoroquinolone use as a risk factor for in vitro fluoroquinolone resistance in ocular cultures. Arch Ophthalmol 2011; 129(4): 399−402.
Lalitha P, Srinivasan M, Manikandan P, Bharathi MJ, Rajaraman R, Ravindran M, et al. Relationship of in vitro susceptibility to moxifloxacin and in vivo clinical outcome in bacterial kerati-tis. Clin Infect Dis 2012; 54(10): 1381−7.
Sueke H, Kaye S, Neal T, Murphy C, Hall A, Whittaker D, et al. Minimum inhibitory concentrations of standard and novel an-timicrobials for isolates from bacterial keratitis. Invest Oph-thalmol Vis Sci 2010; 51(5): 2519−24.
Callegan MC, Novosad BD, Ramadan RT, Wiskur B, Moyer AL. Rate of bacterial eradication by ophthalmic solutions of fourth-generation fluoroquinolones. Adv Ther 2009; 26(4): 447−54.
Chung JL, Lim EH, Song SW, Kim BY, Lee JH, Mah FS, et al. Comparative intraocular penetration of 4 fluoroquinolones af-ter topical instillation. Cornea 2013; 32(7): 1046−51.
Wong CA, Galvis V, Tello A, Villareal D, Rey JJ. In vitro antibiotic susceptibility to fluoroquinolones. Arch Soc Esp Oftalmol 2012; 87(3): 72−8.
Williams L, Malhotra Y, Murante B, Laverty S, Cook S, Topa D, et al. A single-blinded randomized clinical trial comparing polymyxin B-trimethoprim and moxifloxacin for treatment of acute conjunctivitis in children. J Pediatr 2013; 162(4): 857−61.
Steger B, Speicher L, Philipp W, Gasser T, Schmid E, Bechrakis N. Effectiveness of initial antibiotic therapy for treatment of contact lens-related bacterial keratitis. Ophthalmologe 2014; 111(7): 644−8. (German)
Blanco C, Núñez MX. Antibiotic susceptibility of staphylococci isolates from patients with chronic conjunctivitis: Including associated factors and clinical evaluation. J Ocul Pharmacol Ther 2013; 29(9): 803−8.
Shih CY, Bosjolie A, Qiao M, Udell IJ. Bilateral corneal ulceration in keratoconus. Ophthalmology 2012; 119(10): 2192−2192.e3.
Borkar DS, Fleiszig SM, Leong C, Lalitha P, Srinivasan M, Ghanekar AA, et al. Association between cytotoxic and invasive Pseudomonas aeruginosa and clinical outcomes in bacterial keratitis. JAMA Ophthalmol 2013; 131(2): 147−53.
Oldenburg CE, Lalitha P, Srinivasan M, Manikandan P, Bharathi MJ, Rajaraman R, et al. Moxifloxacin susceptibility mediates the relationship between causative organism and clinical outcome in bacterial keratitis. Invest Ophthalmol Vis Sci 2013; 54(2): 1522−6.
Mahvan TD, Hornecker JR, Buckley WA, Clark S. The role of besifloxacin in the treatment of bacterial conjunctivitis. Ann Pharmacother 2014; 48(5): 616−25.
Tauber S, Cupp G, Garber R, Bartell J, Vohra F, Stroman D. Mi-crobiological efficacy of a new ophthalmic formulation of moxifloxacin dosed twice-daily for bacterial conjunctivitis. Adv Ther 2011; 28(7): 566−74.
Srinivasan M, Mascarenhas J, Rajaraman R, Ravindran M, Lalitha P, O'brien KS, et al. The steroids for corneal ulcers trial (SCUT): Secondary 12-month clinical outcomes of a randomized controlled trial. Am J Ophthalmol 2014; 157(2): 327−33.e3.
Constantinou M, Daniell M, Snibson GR, Vu HT, Taylor HR. Clinical efficacy of moxifloxacin in the treatment of bacterial keratitis: A randomized clinical trial. Ophthalmology 2007; 114(9): 1622−9.
Park J, Lee KM, Zhou H, Rabin M, Jwo K, Burton WB, et al. Community practice patterns for bacterial corneal ulcer evaluation and treatment. Eye Contact Lens 2015; 41(1): 12−8.
Sharma C, Velpandian T, Baskar SS, Ranjan BN, Bihari VR, Ghose S. Effect of flouroquinolones on the expression of ma-trix metalloproteinase in debrided cornea of rats. Toxicol Mech Methods 2011; 21(1): 6−12.
Sharma N, Goel M, Bansal S, Agarwal P, Titiyal JS, Upadhyaya AD, et al. Evaluation of moxifloxacin 0.5% in treatment of nonperforated bacterial corneal ulcers: A randomized con-trolled trial. Ophthalmology 2013; 120(6): 1173−8.
Ray KJ, Prajna L, Srinivasan M, Geetha M, Karpagam R, Glidden D, et al. Fluoroquinolone treatment and susceptibility of isolates from bacterial keratitis. JAMA Ophthalmol 2013; 131(3): 310−3.
Kowalski RP, Kowalski TA, Shanks RM, Romanowski EG, Karen-chak LM, Mah FS. In vitro comparison of combination and monotherapy for empiric and optimal coverage of bacterial keratitis based on incidence of infection. Cornea 2013; 32(6): 830−4.
Chawla B, Agarwal P, Tandon R, Titiyal JS, Sharma N, Agarwal T, et al. In vitro susceptibility of bacterial keratitis isolates to fourth-generation flouroquinolones. Eur J Ophthalmol 2010; 20(2): 300−5.
Matsuura K. Pharmacokinetics of subconjunctival injection of moxifloxacin in humans. Graefes Arch Clin Exp Ophthalmol 2013; 251(3): 1019−20.
Keating GM. Moxifloxacin 0.5% ophthalmic solution: In bac-terial conjunctivitis. Drugs 2011; 71(1): 89−99.
Oum BS, Kim NM, Lee JS, Park YM. Effects of flouroquino-lones eye solutions without preservatives on human corneal epithelial cells in vitro. Ophthalmic Res 2014; 51(4): 216−23.
Watanabe R, Nakazawa T, Yokokura S, Kubota A, Kubota H, Ni-shida K. Flouroquinolones antibacterial eye drops: Effects on normal human corneal epithelium, stroma, and endothelium. Clin Ophthalmol 2010; 4(10): 1181−7.
Chen TC, Chang SW, Wang TY. Moxifloxacin modifies corneal fibroblast-to-myofibroblast differentiation. Br J Pharmacol 2013; 168(6): 1341−54.
Agarwal T, Jhanji V, Satpathy G, Nayak N, Chawla B, Tandon R, et al. Moxifloxacin resistance: Intrinsic to antibiotic or related to mutation. Optom Vis Sci 2012; 89(12): 1721−4.
Dutot M, Pouz F. Fluoroquinolone eye drop-induced cytotox-icity: Role of preservative in P2X7 cell receptor activation and apoptosis. Invest Ophthalmol Vis Sci 2006; 47(7): 2812−9.
Le Feuvre R, Brough D, Rothwell N. Extracellular ATP and P2X7 receptors in neurodegeneration. Eur J Pharmacol 2002; 447(2−3): 261−9.
Miras-Portugal MT, Diaz-Hernandez M, Giraldez L, Hervas C, Gomez-Villafuertes R, Sen RP, et al. P2X7 receptors in rat brain: Presence in synaptic terminals and granule cells. Neurochem Res 2003; 28(10): 1597−605.
Labasi JM, Petrushova N, Donovan C, Mccurdy S, Lira P, Payette MM, et al. Absence of the P2X7 receptor alters leukocyte function and attenuates an inflammatory response. J Immunol 2002; 168(12): 6436−45.
Dell'Antonio G, Quattrini A, Cin ED, Fulgenzi A, Ferrero ME. Relief of inflammatory pain in rats by local use of the selective P2X7 ATP receptor inhibitor, oxidizied ATP. Arthritis Rheum 2002; 46(12): 3378−85.
Colomar A, Marty V, Medina C, Combe C, Parnet P, Amedee T. Maturation and release of interleukin-1beta by lipopolysaccha-ride-primed mouse Schwann cells require the stimulation of P2X7 receptors. J Biol Chem 2003; 278(33): 30732−40.
Smart ML, Gu B, Panchal RG, Wiley J, Cromer B, Williams DA, et al. P2X7 receptor cell surface expression and cytolytic pore formation are regulated by a distal C-terminal region. J Biol Chem 2003; 278(10): 8853−60.
Gasset AR. Benzalkonium chloride toxicity to the human cor-nea. Am J Ophthalmol 1977; 84(2): 169−71.
Sheikh A, Hurwitz B, van Schayck CP, Mclean S, Nurmatov U. An-tibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev 2012; 12(9): CD001211.