Antibiotics in Ophthalmology Practice

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 15 July 2024 | Viewed by 8194

Special Issue Editors


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Guest Editor
New Zealand - National Eye Centre, Department of Ophthalmology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
Interests: microbial keratitis; antibiotic resistance; light-based anti-infective technology; phototherapy

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Guest Editor
Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, University of Auckland, Auckland 1142, New Zealand
Interests: ocular drug delivery; non-aqueous; eye drops; dry eye disease; topical
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Special Issue Information

Dear Colleagues,

Antibiotic resistance has been recognized as a global public health threat. The increasing evidence in the literature shows that several antibiotics that used to be highly effective in managing eye infections a few years ago are continuously losing efficacy. Although the problem is common worldwide, the reported rates of antibiotic resistance are highly variable across countries and within the antibiotic classes. This Special Issue aims to publish the latest data on antibiotic resistance in ophthalmology. It will present a snapshot of the problem for different geographical locations and help clinicians choose the right drug for their patients. Original articles and systematic reviews are highly encouraged for submission. Data could comprise retrospective and prospective evaluations of antibiotic efficacy, laboratory-based investigations focusing on ophthalmology practice, or antibiotic resistance patterns within different ophthalmic diseases such as corneal ulcer, conjunctivitis, and endophthalmitis.

Dr. Sanjay Marasini
Dr. Priyanka Agarwal
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • eye infections
  • antibiotic resistance
  • empiric treatment
  • corneal ulcer
  • endophthalmitis
  • microbial keratitis
  • conjunctivitis

Published Papers (5 papers)

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Research

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10 pages, 485 KiB  
Article
Management and Prognosis of Acute Post-Cataract Surgery Endophthalmitis: A 10-Year Retrospective Analysis in Eastern China
by Xiuwen Zhang, Zhi Chen, Xiaoxia Li, Zimei Zhou, Maureen Boost, Taomin Huang and Xingtao Zhou
Antibiotics 2023, 12(12), 1670; https://doi.org/10.3390/antibiotics12121670 - 28 Nov 2023
Viewed by 976
Abstract
Acute post-cataract surgery endophthalmitis (APSE) is a serious vision-threatening complication of cataract surgery. Analysis of the management and prognosis in cases of APSE may provide better guidance for future treatment. Fifty-six patients (56 eyes) diagnosed with APSE between 2013 and 2022 were retrospectively [...] Read more.
Acute post-cataract surgery endophthalmitis (APSE) is a serious vision-threatening complication of cataract surgery. Analysis of the management and prognosis in cases of APSE may provide better guidance for future treatment. Fifty-six patients (56 eyes) diagnosed with APSE between 2013 and 2022 were retrospectively reviewed. The incidence of APSE rate was 0.020% (95% CI: 0.011–0.029%). Intraocular cultures were positive in 18 (32.1%) cases, with 21 organisms isolated. Coagulase-negative staphylococci was the predominant isolate (12/21; 57.1%). The time from surgery to the onset of endophthalmitis was 7 days (interquartile range: 3–16) in patients with good best-corrected visual acuity (BCVA) (≥20/70) and 3 days (interquartile range: 1–8) in those with poor BCVA (<20/70). Multivariate linear regression analysis revealed that initial BCVA (logMAR) (p < 0.001), time from onset to initial intravitreal antibiotics (IVAs) (p < 0.001), and positive culture of highly virulent pathogens (p = 0.018) displayed significantly positive associations with the final BCVA (logMAR). Adjunctive use of intravitreal corticosteroids and systemic antibiotics were unrelated to a favorable final BCVA. In conclusion, the severity of the visual condition at baseline, as well as delayed treatment, are risk factors for poor visual outcomes in APSE. Full article
(This article belongs to the Special Issue Antibiotics in Ophthalmology Practice)
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11 pages, 269 KiB  
Article
Role of Antimicrobial Resistance in Outcomes of Acute Endophthalmitis
by Aaron Yap, Sharmini Muttaiyah, Sarah Welch and Rachael L. Niederer
Antibiotics 2023, 12(8), 1246; https://doi.org/10.3390/antibiotics12081246 - 28 Jul 2023
Cited by 4 | Viewed by 1097
Abstract
Background: This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. Methods: All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 2006–May 2023 were included. The impact of antimicrobial [...] Read more.
Background: This study explores local trends in antimicrobial resistance and its influence on long-term visual outcomes following treatment with broad-spectrum empiric intravitreal antibiotics. Methods: All patients undergoing intraocular sampling for endophthalmitis from Auckland between January 2006–May 2023 were included. The impact of antimicrobial resistance on the final visual outcome was analysed using logistic regression models. Results: 389 cases of endophthalmitis were included, and 207 eyes (53.2%) were culture positive. When tested, all Gram-positive microorganisms were fully susceptible to Vancomycin, and all Gram-negative microorganisms demonstrated full or intermediate susceptibility to Ceftazidime. Resistance to at least one antimicrobial agent was present in 89 culture results (43.0%), and multidrug resistance (resistant to ≥3 antimicrobials) in 23 results (11.1%). No increase in resistance was observed over time. The primary procedure was a tap and inject in 251 eyes (64.5%), and early vitrectomy was performed in 196 eyes (50.3%). Severe vision loss (≤20/200) occurred in 167 eyes (42.9%). Antimicrobial resistance was associated with an increased risk of retinal detachment (OR 2.455 p = 0.048) but not vision loss (p = 0.288). Conclusion: High sensitivity to Vancomycin and Ceftazidime was present in our population, reinforcing their role as first-line empiric treatments. Resistant microorganisms were associated with an increased risk of retinal detachment but no alteration in final visual outcome. Full article
(This article belongs to the Special Issue Antibiotics in Ophthalmology Practice)
7 pages, 392 KiB  
Communication
Ocular Antibiotic Utilisation across Aotearoa/New Zealand
by Isabella M. Y. Cheung, Simon Horsburgh, Mohammed Ziaei and Akilesh Gokul
Antibiotics 2023, 12(6), 1007; https://doi.org/10.3390/antibiotics12061007 - 4 Jun 2023
Cited by 1 | Viewed by 1235
Abstract
Ocular antibiotics are integral to the prevention and treatment of bacterial ocular infections. This study aimed to describe their utilisation across New Zealand according to patient and healthcare factors. Every subsidy-eligible community dispensing of ocular chloramphenicol, fusidic acid and ciprofloxacin in New Zealand, [...] Read more.
Ocular antibiotics are integral to the prevention and treatment of bacterial ocular infections. This study aimed to describe their utilisation across New Zealand according to patient and healthcare factors. Every subsidy-eligible community dispensing of ocular chloramphenicol, fusidic acid and ciprofloxacin in New Zealand, between 2010 and 2019, was included in this analysis. Number of dispensings/1000 population/year was quantified, stratified by patient age and urban/non-urban health districts. Dispensing rates by ethnicity were determined and were age adjusted. The proportion of dispensings by socioeconomic deprivation quintile was also determined. Chloramphenicol was the most commonly dispensed antibiotic; however, its utilisation decreased over time. Ciprofloxacin use was higher in children, while chloramphenicol use was higher in older patients. Ciprofloxacin usage was higher among Māori and Pasifika ethnicities, while fusidic acid use was lower. Chloramphenicol usage was higher among Pasifika. Antibiotic utilisation was higher in urban health districts, and in the most deprived quintile; both were most marked with ciprofloxacin. The utilisation of publicly funded ocular antibiotics across New Zealand varied between patient subgroups. These findings will help improve the prevention, management and outcomes of bacterial ocular infections, and support wider initiatives in antibiotic stewardship and medicine access equity. Full article
(This article belongs to the Special Issue Antibiotics in Ophthalmology Practice)
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11 pages, 1450 KiB  
Article
Effect of Antibiotic Eye Drops on the Nasal Microbiome in Healthy Subjects—A Pilot Study
by Clemens Nadvornik, Martin Kallab, Nikolaus Hommer, Andreas Schlatter, Theresa Stengel, Gerhard Garhöfer, Markus Zeitlinger, Sabine Eberl, Ingeborg Klymiuk, Slave Trajanoski, Marion Nehr, Athanasios Makristathis, Doreen Schmidl and Alina Nussbaumer-Proell
Antibiotics 2023, 12(3), 517; https://doi.org/10.3390/antibiotics12030517 - 4 Mar 2023
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Abstract
Background: Antibiotic eye drops are frequently used in clinical practice. Due to the anatomical connection via the nasolacrimal duct, it seems possible that they have an influence on the nasal/pharyngeal microbiome. This was investigated by using two different commonly used antibiotic eye drops. [...] Read more.
Background: Antibiotic eye drops are frequently used in clinical practice. Due to the anatomical connection via the nasolacrimal duct, it seems possible that they have an influence on the nasal/pharyngeal microbiome. This was investigated by using two different commonly used antibiotic eye drops. Methods: 20 subjects were randomized to four groups of five subjects receiving eye drops containing gentamicin, ciprofloxacin, or, as controls, unpreserved povidone or benzalkonium chloride-preserved povidone. Nasal and pharyngeal swabs were performed before and after the instillation period. Swabs were analyzed by Illumina next-generation sequencing (NGS)-based 16S rRNA analysis. Bacterial culture was performed on solid media, and bacterial isolates were identified to the species level by MALDI-TOF MS. Species-dependent antimicrobial susceptibility testing was performed using single isolates and pools of isolates. Results: Bacterial richness in the nose increased numerically from 163 ± 30 to 243 ± 100 OTUs (gentamicin) and from 114 ± 17 to 144 ± 45 OTUs (ciprofloxacin). Phylogenetic diversity index (pd) of different bacterial strains in the nasal microbiome increased from 12.4 ± 1.0 to 16.9 ± 5.6 pd (gentamicin) and from 10.2 ± 1.4 to 11.8 ± 3.1 pd (ciprofloxacin). Unpreserved povidone eye drops resulted in minimal changes in bacterial counts. Preservative-containing povidone eye drops resulted in no change. A minor increase (1–2-fold) in the minimal inhibitory concentration (MIC) was observed in single streptococcal isolates. Conclusions: Antibiotic eye drops could affect the nasal microbiome. After an instillation period of seven days, an increase in the diversity and richness of bacterial strains in the nasal microbiome was observed. Full article
(This article belongs to the Special Issue Antibiotics in Ophthalmology Practice)
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Review

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17 pages, 1188 KiB  
Review
Managing Corneal Infections: Out with the old, in with the new?
by Sanjay Marasini, Jennifer P. Craig, Simon J. Dean and Leon G. Leanse
Antibiotics 2023, 12(8), 1334; https://doi.org/10.3390/antibiotics12081334 - 18 Aug 2023
Cited by 1 | Viewed by 1906
Abstract
There have been multiple reports of eye infections caused by antibiotic-resistant bacteria, with increasing evidence of ineffective treatment outcomes from existing therapies. With respect to corneal infections, the most commonly used antibiotics (fluoroquinolones, aminoglycosides, and cephalosporines) are demonstrating reduced efficacy against bacterial keratitis [...] Read more.
There have been multiple reports of eye infections caused by antibiotic-resistant bacteria, with increasing evidence of ineffective treatment outcomes from existing therapies. With respect to corneal infections, the most commonly used antibiotics (fluoroquinolones, aminoglycosides, and cephalosporines) are demonstrating reduced efficacy against bacterial keratitis isolates. While traditional methods are losing efficacy, several novel technologies are under investigation, including light-based anti-infective technology with or without chemical substrates, phage therapy, and probiotics. Many of these methods show non-selective antimicrobial activity with potential development as broad-spectrum antimicrobial agents. Multiple preclinical studies and a limited number of clinical case studies have confirmed the efficacy of some of these novel methods. However, given the rapid evolution of corneal infections, their treatment requires rapid institution to limit the impact on vision and prevent complications such as scarring and corneal perforation. Given their rapid effects on microbial viability, light-based technologies seem particularly promising in this regard. Full article
(This article belongs to the Special Issue Antibiotics in Ophthalmology Practice)
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