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Removal of intraocular foreign bodies
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
William J Wirostko, Sumit Bhatia, William F Mieler, Cathleen M McCabe
Intravitreal antibiotic levels can be prolonged with intravenous agents. Intravenous cefazolin (1 g every 8 hours, adult dose),57 ceftazidime (1 g every 8 hours, adult dose),40,58 vancomycin (1 g every 12 hours, adult dose)59 and ciprofloxacin (400 mg every 12 hours, adult dose),60 all cross the blood–ocular barrier to some extent, and provide broad coverage. Regarding the use of systemic antibiotics, however, over the past several years we have switched recommendations, and rarely employ intravenous antibiotics, even in the setting of proven ocular infection. Previously, intravenous vancomycin in combination with a third-generation cephalosporin or ciprofloxacin was employed for 1–3 days. Oral ciprofloxacin (750 mg every 12 hours, adult dose) is capable of achieving therapeutic levels, but requires multiple doses over several days.61 More recently, oral fourth-generation fluoroquinolones such as gatifloxacin (400 mg for two doses 12 hours apart) achieves mean inhibitory vitreous and aqueous MIC90 levels against many bacterial species encountered in posttraumatic endophthalmitis.62 Oral gatifloxacin is then continued orally at 400 mg/day for 5–7 days. We discourage the use of intravenous amino-glycosides such as gentamicin, because they do not consistently achieve therapeutic intravitreal levels57,63 and there is potential for significant morbidity.
Gatifloxacin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
James Owen Robinson, Keryn Christiansen
Gatifloxacin is an 8-methoxy-fluoroquinolone and is marketed by Bristol Myers Squibb as Tequin, having licensed the medication from the Kyorin Pharmaceutical Company in Japan. It is known by a variety of proprietary names pursuant to the formulation and the country in which it is marketed. Three formulations are available, oral, ophthalmic, and intravenous. Like other members of this class, gatifloxacin has activity against many Gram-positive and Gram-negative bacteria and many intracellular respiratory pathogens. In particular it has activity against penicillin-susceptible and -resistant Streptococcus pneumoniae, methicillin-susceptible Staphylococcus aureus (MSSA), and some anaerobes. Unlike ciprofloxacin it lacks significant activity against Pseudomonas aeruginosa.
Quinolones
Published in Thomas T. Yoshikawa, Shobita Rajagopalan, Antibiotic Therapy for Geriatric Patients, 2005
Thomas J. Marrie, Susan Fryters
The usual dosage of ciprofloxacin is 500 or 750 mg twice daily orally (PO), while the intravenous (IV) dosage is 400 mg every 12 hr, or every 8 hr for serious infections. Gatifloxacin is given as 400 mg IV or PO once daily. Levofloxacin is also available in IV and oral formulations. The dosage is 500 or 750 mg once daily. Moxifloxacin is available as an oral and IV formulation in a dosage of 400 mg once daily. Gemifloxacin is available as a 320 mg oral tablet taken once daily.
Chronic canaliculitis with canaliculoliths due to Providencia stuartii infection
Published in Orbit, 2023
Jenny Lin, Victoria S. North, Christopher Starr, Kyle J. Godfrey
Conservative therapy – topical antibiotics without canaliculotomy – is inadequate in treating canaliculitis with canaliculoliths, and these patients may ultimately present with recurrent and chronic canaliculitis.1–4 Typically, canaliculoliths should be surgically removed as early as possible due to their ability to shield the bacteria from antibiotic eye drops and potentially lead to resistance and inadequate response. Conservative management may also select for disease-causing pathogens by eliminating the competitive pressure of other flora sensitive to the agent of choice. In the present case, treatment with gatifloxacin may have conferred cross-resistance within the fluoroquinolone class, potentially explaining her initial improvement on gatifloxacin and ultimate resistance to levofloxacin.11,12
Equivalent effect of extracellular proteins and polysaccharides on biofilm formation by clinical isolates of Staphylococcus lugdunensis
Published in Biofouling, 2021
Weidong Qian, Wenjing Wang, Jianing Zhang, Miao Liu, Yuting Fu, Mingming Li, Jing Jin, Wei Cui, Chengbin Wang
3-D gatifloxacin diffusion and distribution in biofilms were measured based on the intrinsic fluorescence using CLSM as described previously (Jegal et al. 2019), with modifications. The biofilms were pre-formed on glass coverslips placed inside a 24-well plate (Corning, NY, United States). A 1,000-μl cell suspension containing 106 CFU ml−1 in fresh TSBgluc was inoculated into each well of the plate and incubated for 24 h at 37 °C with or without the addition of EPS-degrading agents. After incubation, the biofilms were gently washed three times with 10 mM PBS, and gatifloxacin at a final concentration of 0.4 mg ml−1 was added following which they were further incubated for 4 h at 37 °C. Next, to visualize the diffusion of the gatifloxacin within the biofilms, the fluorescent dye of SYTO 9 was added to the biofilms to a final concentration of 3 μM. The biofilms were incubated for 15 min, washed three times with 10 mM PBS to remove non-penetrated gatifloxacin, and observed by CLSM. To assess the structure and size of the biofilms, a series of images in the z-axis were obtained for the full depth of the biofilm. At least three random fields were visualized for each biofilm, and representative images are presented.
Guidelines for the treatment of dysentery (shigellosis): a systematic review of the evidence
Published in Paediatrics and International Child Health, 2018
Phoebe C. M. Williams, James A. Berkley
Gatifloxacin, a fourth-generation fluoroquinolone, was investigated as an alternative therapy in a multi-centre randomised trial assessing the efficacy of gatifloxacin vs ciprofloxacin for shigellosis in Vietnamese children between 2006 and 2008 [17]. No superiority to gatifloxacin was found in terms of clinical failure rates which were similar in both groups (gatifloxacin 12% vs 11% for ciprofloxacin, p = 0.72), with gatifloxacin showing similar efficacy in the treatment of paediatric dysentery [2]. However, while gatifloxacin might be more convenient than ciprofloxacin owing to its longer half-life (allowing administration once daily rather than twice daily as required for ciprofloxacin), retrospective review of clinical outcomes in patients treated with gatifloxacin revealed significantly poorer clinical outcomes than in those treated with ciprofloxacin, regardless of isolate minimum inhibitory concentrations (MIC). Overall, no association between MIC and clinical outcome in paediatric shigellosis was found [17].