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A comparison of moxifloxacin and levofloxacin topical prophylaxis in a fluoroquinolone-resistant Staphylococcus aureus rabbit model

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Abstract

Purpose

Moxifloxacin, a fourth-generation fluoroquinolone (FQ), was compared to levofloxacin, a thirdgeneration FQ, for preventing FQ-resistant, methicillin-resistant Staphylococcus aureus (FQrMRSA) endophthalmitis in a rabbit model.

Methods

Three regimens of topical treatments (moxifloxacin 0.5%, levofloxacin 0.5%, and saline) were tested to prevent endophthalmitis. For each regimen, drops were instilled every 15 min for 1 h into the left eyes of 15 rabbits. After anesthesia, 2 × 104 cfu of FQrMRSA was injected into the aqueous. One drop of treatment was given immediately, and another four drops were applied over 24 h. At 24 h, the eyes were clinically graded for endophthalmitis. After the rabbits were sacrificed, the aqueous and vitreous were tapped for bacterial colony counts.

Results

Topical moxifloxacin (12/15, 80%) significantly (P = 0.0001) prevented clinical endophthalmitis in more rabbits than levofloxacin (2/15, 13%) or saline (2/15, 13%). The total median clinical score for moxifloxacin treatment (1.0) was significantly (P = 0.0004) lower than that for levofloxacin (20.0) or saline (23.0). Culture-negative eyes were less frequent for levofloxacin (8/15, 53%) and saline (1/15, 7%) treatments than for moxifloxacin treatment (12/15, 80%).

Conclusion

This in vivo study indicates that moxifloxacin, a fourth-generation FQ, may be more effective than levofloxacin, a third-generation FQ, in preventing experimental FQrMRSA. endophthalmitis.

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Authors and Affiliations

  1. The Charles T. Campbell Ophthalmic Microbiology Laboratory, The University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Regis P. Kowalski, Eric G. Romanowski, Francis S. Mah & Y. J. Gordon

  2. UPMC Eye Center, Ophthalmology and Visual Science Research Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Regis P. Kowalski, Eric G. Romanowski, Francis S. Mah & Y. J. Gordon

  3. Department of Ophthalmology Division of Sensory Organ Medicine, Kanazawa Medical University, Ishikawa, Kanazawa, Japan

    Hiroshi Sasaki & Masamichi Fukuda

Authors
  1. Regis P. Kowalski
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  2. Eric G. Romanowski
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  3. Francis S. Mah
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  4. Hiroshi Sasaki
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  5. Masamichi Fukuda
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  6. Y. J. Gordon
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Corresponding author

Correspondence to Regis P. Kowalski.

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Kowalski, R.P., Romanowski, E.G., Mah, F.S. et al. A comparison of moxifloxacin and levofloxacin topical prophylaxis in a fluoroquinolone-resistant Staphylococcus aureus rabbit model. Jpn J Ophthalmol 52, 211–216 (2008). https://doi.org/10.1007/s10384-008-0530-1

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  • DOI: https://doi.org/10.1007/s10384-008-0530-1

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