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Comparison of the effect of teicoplanin and vancomycin on experimental methicillin-resistant staphylococcus aureus keratitis

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Abstract

Purpose

To evaluate the early efficacy and safety of intrastromal injection of teicoplanin as the alternative treatment for the methicillin-resistant Staphylococcus aureus (MRSA) keratitis by comparing it with vancomycin.

Materials and methods

Twenty-four eyes of 24 New Zealand white rabbits were included in the study. MRSA keratitis was induced in the right eye of each rabbit by injecting 0.1 mL MRSA suspension containing 1000 colony-forming units (CFU) intrastromally to the central cornea. The rabbits were divided into three treatment groups 24 h after the inoculation of MRSA. Eight rabbits received intrastromal teicoplanin therapy, eight received intrastromal vancomycin therapy, and eight received balanced salt solution and served as the control group. Nine hours after the treatment, all rabbits were sacrificed and corneal tissues were collected for microbiological analysis. We also examined and scored all the rabbits clinically before and after the treatment.

Results

The control group scored higher with regard to conjunctival injection, iritis, fibrin, hypopyon, epithelial erosion, and corneal infiltrate than the vancomycin and teicoplanin groups (p = 0.031, 0.010, < 0.001, 0.029, 0.009, and < 0.001, respectively). Chemosis and corneal oedema were similar in all groups (p = 0.731 and 0.075, respectively). The severity of all clinical parameters was similar in both the vancomycin and teicoplanin groups after the treatment. The bacterial load was the highest (7.83 ± 0.71 log10 CFU/g) in the control group. The eyes treated with vancomycin and teicoplanin had similar bacterial loads (6.40 ± 0.69 vs. 6.31 ± 0.75 log10 CFU/g, p = 0.809).

Conclusion

The efficiency of teicoplanin seems to be comparable to that of vancomycin when administered intrastromally in the early treatment of MRSA keratitis. The former may be preferred in the treatment of selected cases with vancomycin hypersensitivity or resistance.

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Authors and Affiliations

  1. Department of Ophthalmology, Training and Research Hospital, Bolu Abant Izzet Baysal University, Kılıçarslan Mah. 144. Sk No: 7/6 Merkez, Bolu, Turkey

    Ahmet Yucel Ucgul

  2. Department of Medical Microbiology, Training and Research Hospital, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Mustafa Behcet

Authors
  1. Ahmet Yucel Ucgul
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  2. Mustafa Behcet
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Contributions

AYU and MB designed and conducted the study. MB made substantial contributions to acquisition of microbiological data. AYU wrote the manuscript. Two authors read and approved the final manuscript.

Corresponding author

Correspondence to Ahmet Yucel Ucgul.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

The Animal Experiments Local Ethics Committee at the University of Abant Izzet Baysal (Bolu, Turkey) approved the study (Approval No: 2019/41).

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Ucgul, A.Y., Behcet, M. Comparison of the effect of teicoplanin and vancomycin on experimental methicillin-resistant staphylococcus aureus keratitis. Int Ophthalmol 41, 1395–1402 (2021). https://doi.org/10.1007/s10792-021-01696-2

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  • DOI: https://doi.org/10.1007/s10792-021-01696-2

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