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Does in vitro susceptibility predict clinical outcome in bacterial keratitis? 2008

Aiyin Chen, and Lalitha Prajna, and Muthiah Srinivasan, and Rajendran Mahalakshmi, and John P Whitcher, and Stephen McLeod, and Thomas M Lietman, and Nisha R Acharya
F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, San Francisco, California 94143, USA.

OBJECTIVE To determine whether clinical outcomes in bacterial keratitis are associated with antibiotic susceptibility. METHODS Retrospective, ancillary study using data and samples from a completed randomized clinical trial. METHODS Forty-two patients were enrolled with culture-confirmed bacterial keratitis at Aravind Eye Hospital in South India. All patients received topical moxifloxacin and were randomized to receive either topical prednisolone phosphate or placebo. Outcomes included time to epithelialization, best spectacle-corrected visual acuity (BSCVA), and infiltrate/scar size at three months. Bacterial isolates were cultured, and minimum inhibitory concentration (MIC) to moxifloxacin was measured using Etests. Multiple linear regression was used to assess the effect of MIC on outcome, adjusting for enrollment characteristics. RESULTS MIC was associated with three-month infiltrate/scar size: each two-fold increase in MIC was associated with a 0.33-mm average diameter increase in scar size (P=.01). MIC was not associated with three-month BSCVA (P=.71) or time to epithelialization (P=.35). CONCLUSIONS MIC was associated with infiltrate/scar size in bacterial keratitis. An ongoing larger, multicenter trial should provide further information on whether this association is maintained across subgroups of organisms.

UI MeSH Term Description Entries
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D011239 Prednisolone A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. Di-Adreson-F,Predate,Predonine,Di Adreson F,DiAdresonF
D011804 Quinolines
D003320 Corneal Ulcer Loss of epithelial tissue from the surface of the cornea due to progressive erosion and necrosis of the tissue; usually caused by bacterial, fungal, or viral infection. Keratitis, Ulcerative,Keratitides, Ulcerative,Ulcer, Corneal,Ulcerative Keratitides,Ulcerative Keratitis
D004198 Disease Susceptibility A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. Diathesis,Susceptibility, Disease,Diatheses,Disease Susceptibilities,Susceptibilities, Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077266 Moxifloxacin A fluoroquinolone that acts as an inhibitor of DNA TOPOISOMERASE II and is used as a broad-spectrum antibacterial agent. 1-Cyclopropyl--7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinolinecarboxylic acid,Actira,Avalox,Avelox,BAY 12-8039,BAY 128039,BAY-12-8039,BAY-128039,Izilox,Moxifloxacin Hydrochloride,Octegra,Proflox,BAY 12 8039,BAY128039
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D001372 Aza Compounds Organic chemicals where carbon atoms have been replaced by nitrogen atoms. Compounds, Aza

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