Date: 14 Nov 2003

Intravenous treatment of experimental Staphylococcus aureus endophthalmitis: imipenem versus the combination of ceftazidime and amikacin

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Abstract

Background: To compare the efficacy of intravenous (IV) imipenem (IPM) and a combination of IV ceftazidime (CAZ) and amikacin (AN) in the treatment of Staphylococcus aureus endophthalmitis in a rabbit model. Methods: Right eyes of 60 albino rabbits were injected with 1000 colony-forming units of S. aureus intravitreally. After 24 h, treatment with either IV IPM (37.5 mg/kg) every 8 h (n=18) or IV CAZ (50 mg/kg) and AN (10 mg/kg) every 8 hours (n=18) was begun and continued until the animals were killed at the indicated timepoints; 24 control animals received no treatment. The concentration of bacteria in the vitreous from six animals per group was determined microbiologically on days 2, 3, and 5 after infection, and histologic examination was performed on all eyes. Results: The number of eyes with positive cultures on day 5 was lower in the group that received IV IPM (2/6) compared with the IV CAZ/AN group (4/6) and the control group (6/6). For the culture-positive eyes, the bacterial concentrations were significantly lower for the IV IPM group compared with the IV CAZ/AN group on days 2 and 5 (P<0.05 and P<0.0065, respectively), but not on day 3 (P <0.8. Bacterial counts in both treatment groups were significantly lower than in the control group (P<0.005). Eyes in all groups, however, showed severe intraocular inflammation. Conclusions: IV IPM is more effective than is IV CAZ/AN in reducing the number of bacteria in an animal model of S.aureus endophthalmitis.

This work was presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Ft. Lauderdale, Florida, May 1997 and of the Deutsche Ophthalmologische Gesellschaft, Berlin, Germany, October 1997.
The authors have no proprietary interest in any of the products used in this study.
This study contributes to M. Engelbert’s medical dissertation at Ludwig-Maximilians-Universität.
This work was supported in part by the Dr. Georg und Hannelore Zimmermann Foundation, Munich, Germany and the Dr. Helmut und Margarete Meyer-Schwarting Foundation, Bremen, Germany.