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Erschienen in: Japanese Journal of Ophthalmology 6/2022

01.10.2022 | Clinical Investigation

Analysis of treatment protocols using azithromycin eye drops for bacterial blepharitis: second report—bacteriological investigation

verfasst von: Ryohei Nejima, Hiroshi Eguchi, Daisuke Todokoro, Tomoyuki Inoue, Yuichi Kaji, Takashi Suzuki, Takaaki Hattori, Saichi Hoshi, Yumi Sasaki, Yoshitsugu Inoue

Erschienen in: Japanese Journal of Ophthalmology | Ausgabe 6/2022

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Abstract

Purpose

To gain new insights into the etiology of blepharitis, we investigated the causative bacteria in patients with blepharitis and the effects of 1% azithromycin ophthalmic solution.

Study design

A multicenter, prospective observational study.

Methods

After the subjects were diagnosed as having blepharitis they were administered 1% azithromycin ophthalmic solution for up to 14 days. Bacterial cultures and smear microscopic examinations of the eyelid margin were conducted at the initial visit, after administering eye drops, and 1 month after the end of eye drop administration. The minimum inhibitory concentrations (MICs) of azithromycin were measured.

Results

At the initial visit, the bacterial morphology determined by smear microscopic examinations coincided with that of strains isolated by culture taken from 22 of 45 patients. All detected bacteria were gram-positive, and Corynebacterium spp., Cutibacterium acnes, Staphylococcus epidermidis, Streptococcus spp., and Enterococcus faecalis were isolated most commonly. Compared with the initial visit the number of isolated strains per eye decreased significantly at 7 days after the start of eye drop administration and 1 month after the end of eye drop administration. The azithromycin MICs were temporarily increased after the start of eye drops but then decreased.

Conclusion

Our study suggests that in blepharitis pathogenicity is characterized by increased strain numbers and amounts of indigenous bacteria. Administering a 1% azithromycin ophthalmic solution suppresses the number of bacterial strains within 1 month after the end of eye drop administration without increasing drug resistance.
Literatur
1.
Zurück zum Zitat Amescua G, Akpek EK, Farid M, Garcia-Ferrer FJ, Lin A, Rhee MK, et al. Blepharitis preferred practice Pattern®. Ophthalmology. 2019;126:56–93.CrossRef Amescua G, Akpek EK, Farid M, Garcia-Ferrer FJ, Lin A, Rhee MK, et al. Blepharitis preferred practice Pattern®. Ophthalmology. 2019;126:56–93.CrossRef
3.
Zurück zum Zitat Nejima R, Shimizu K, Ono T, Noguchi Y, Yagi A, Iwasaki T, et al. Effect of the administration period of perioperative topical levofloxacin on normal conjunctival bacterial flora. J Cataract Refract Surg. 2017;43:42–8.CrossRef Nejima R, Shimizu K, Ono T, Noguchi Y, Yagi A, Iwasaki T, et al. Effect of the administration period of perioperative topical levofloxacin on normal conjunctival bacterial flora. J Cataract Refract Surg. 2017;43:42–8.CrossRef
4.
Zurück zum Zitat Haque RM, Torkildsen GL, Brubaker K, Zink RC, Kowalski RP, Mah FS, et al. Multicenter open-label study evaluating the efficacy of azithromycin ophthalmic solution 1% on the signs and symptoms of subjects with blepharitis. Cornea. 2010;29:871–7.CrossRef Haque RM, Torkildsen GL, Brubaker K, Zink RC, Kowalski RP, Mah FS, et al. Multicenter open-label study evaluating the efficacy of azithromycin ophthalmic solution 1% on the signs and symptoms of subjects with blepharitis. Cornea. 2010;29:871–7.CrossRef
5.
Zurück zum Zitat Dougherty JM, McCulley JP. Comparative bacteriology of chronic blepharitis. Br J Ophthalmol. 1984;68:524–8.CrossRef Dougherty JM, McCulley JP. Comparative bacteriology of chronic blepharitis. Br J Ophthalmol. 1984;68:524–8.CrossRef
6.
Zurück zum Zitat Huber-Spitzy V, Baumgartner I, Böhler-Sommeregger K, Grabner G. Blepharitis—a diagnostic and therapeutic challenge. A report on 407 consecutive cases. Graefes Arch Clin Exp Ophthalmol. 1991;229:224–7.CrossRef Huber-Spitzy V, Baumgartner I, Böhler-Sommeregger K, Grabner G. Blepharitis—a diagnostic and therapeutic challenge. A report on 407 consecutive cases. Graefes Arch Clin Exp Ophthalmol. 1991;229:224–7.CrossRef
7.
Zurück zum Zitat Groden LR, Murphy B, Rodnite J, Genvert GI. Lid flora in blepharitis. Cornea. 1991;10:50–3.CrossRef Groden LR, Murphy B, Rodnite J, Genvert GI. Lid flora in blepharitis. Cornea. 1991;10:50–3.CrossRef
8.
Zurück zum Zitat Zhu M, Cheng C, Yi H, Lin L, Wu K. Quantitative analysis of the bacteria in blepharitis with demodex infestation. Front Microbiol. 2018;9:1719.CrossRef Zhu M, Cheng C, Yi H, Lin L, Wu K. Quantitative analysis of the bacteria in blepharitis with demodex infestation. Front Microbiol. 2018;9:1719.CrossRef
9.
Zurück zum Zitat de Paula A, Oliva G, Barraquer RI, de la Paz MF. Prevalence and antibiotic susceptibility of bacteria isolated in patients affected with blepharitis in a tertiary eye centre in Spain. Eur J Ophthalmol. 2020;30:991–7.CrossRef de Paula A, Oliva G, Barraquer RI, de la Paz MF. Prevalence and antibiotic susceptibility of bacteria isolated in patients affected with blepharitis in a tertiary eye centre in Spain. Eur J Ophthalmol. 2020;30:991–7.CrossRef
10.
Zurück zum Zitat Suzuki T, Mitsuishi Y, Sano Y, Yokoi N, Kinoshita S. Phlyctenular keratitis associated with Meibomitis in young patients. Am J Ophthalmol. 2005;140:77–82.CrossRef Suzuki T, Mitsuishi Y, Sano Y, Yokoi N, Kinoshita S. Phlyctenular keratitis associated with Meibomitis in young patients. Am J Ophthalmol. 2005;140:77–82.CrossRef
11.
Zurück zum Zitat Suzuki T, Yokoi N, Kinoshita S. Clinical features of Meibomitis-relates keratoconjunctivitis in elderly patients. Atarashii Ganka (J Eye). 2018;35:389–94 (in Japanese). Suzuki T, Yokoi N, Kinoshita S. Clinical features of Meibomitis-relates keratoconjunctivitis in elderly patients. Atarashii Ganka (J Eye). 2018;35:389–94 (in Japanese).
12.
Zurück zum Zitat Inoue Y, Ohashi Y, Hatano H, Shimomura Y, Sakamoto M, Okamoto Y, et al. Determination of causative agents in ocular infection of external adnexa and anterior segments-multicenter study of causative agents and drug sensitivity of ocular infection by the Japanese Association for Ocular Infection part I. Nippon Ganka Gakkai Zasshi. 2011;115:801–13 (In Japanese). Inoue Y, Ohashi Y, Hatano H, Shimomura Y, Sakamoto M, Okamoto Y, et al. Determination of causative agents in ocular infection of external adnexa and anterior segments-multicenter study of causative agents and drug sensitivity of ocular infection by the Japanese Association for Ocular Infection part I. Nippon Ganka Gakkai Zasshi. 2011;115:801–13 (In Japanese).
13.
Zurück zum Zitat La Scolea Jr LJ, Dryja D. Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance. J Clin Microbiol. 1984;19:187–90.CrossRef La Scolea Jr LJ, Dryja D. Quantitation of bacteria in cerebrospinal fluid and blood of children with meningitis and its diagnostic significance. J Clin Microbiol. 1984;19:187–90.CrossRef
14.
Zurück zum Zitat Nejima R, Inoue T, Kaji Y, Suzuki T, Hattori T, Hoshi S, et al. Analysis of treatment protocols using azithromycin eye drops for bacterial blepharitis—first report: study of clinical course. Atarashii Ganka (J Eye). 2022;39:999–1004 (in Japanese). Nejima R, Inoue T, Kaji Y, Suzuki T, Hattori T, Hoshi S, et al. Analysis of treatment protocols using azithromycin eye drops for bacterial blepharitis—first report: study of clinical course. Atarashii Ganka (J Eye). 2022;39:999–1004 (in Japanese).
17.
Zurück zum Zitat Everett SL, Kowalski RP, Karenchak LM, Landsittel D, Day R, Gordon YJ. An in vitro comparison of the susceptibilities of bacterial isolates from patients with conjunctivitis and blepharitis to newer and established topical antibiotics. Cornea. 1995;14:382–7.CrossRef Everett SL, Kowalski RP, Karenchak LM, Landsittel D, Day R, Gordon YJ. An in vitro comparison of the susceptibilities of bacterial isolates from patients with conjunctivitis and blepharitis to newer and established topical antibiotics. Cornea. 1995;14:382–7.CrossRef
18.
Zurück zum Zitat Inoue Y, Usui M, Ohashi Y, Shiota H, Yamazaki T, Preoperative Disinfection Study Group. Preoperative disinfection of the conjunctival sac with antibiotics and iodine compounds: a prospective randomized multicenter study. Jpn J Ophthalmol. 2008;52:151–61.CrossRef Inoue Y, Usui M, Ohashi Y, Shiota H, Yamazaki T, Preoperative Disinfection Study Group. Preoperative disinfection of the conjunctival sac with antibiotics and iodine compounds: a prospective randomized multicenter study. Jpn J Ophthalmol. 2008;52:151–61.CrossRef
19.
Zurück zum Zitat Suzuki T, Tanaka H, Toriyama K, Okamoto S, Urabe K, Hashida M, et al. Prospective clinical evaluation of 1.5% levofloxacin ophthalmic solution in ophthalmic perioperative disinfection. J Ocul Pharmacol Ther. 2013;29:887–92.CrossRef Suzuki T, Tanaka H, Toriyama K, Okamoto S, Urabe K, Hashida M, et al. Prospective clinical evaluation of 1.5% levofloxacin ophthalmic solution in ophthalmic perioperative disinfection. J Ocul Pharmacol Ther. 2013;29:887–92.CrossRef
20.
Zurück zum Zitat Ono T, Nejima R, Iwasaki T, Mori Y, Noguchi Y, Yagi A, et al. Long-term effects of cataract surgery with topical levofloxacin on ocular bacterial flora. J Cataract Refract Surg. 2017;43:1129–34.CrossRef Ono T, Nejima R, Iwasaki T, Mori Y, Noguchi Y, Yagi A, et al. Long-term effects of cataract surgery with topical levofloxacin on ocular bacterial flora. J Cataract Refract Surg. 2017;43:1129–34.CrossRef
21.
Zurück zum Zitat Papa V, Blanco AR, Santocono M. Ocular flora and their antibiotic susceptibility in patients having cataract surgery in Italy. J Cataract Refract Surg. 2016;42:1312–7.CrossRef Papa V, Blanco AR, Santocono M. Ocular flora and their antibiotic susceptibility in patients having cataract surgery in Italy. J Cataract Refract Surg. 2016;42:1312–7.CrossRef
22.
Zurück zum Zitat Suzuki T, Todokoro D, Kobayakawa S, Sotozono C, Eguchi S, Miyata K, et al. Postcataract endophthalmitis caused by Enterococcus faecalis. Nippon Ganka Gakkai Zasshi. 2014;118:22–7 (in Japanese). Suzuki T, Todokoro D, Kobayakawa S, Sotozono C, Eguchi S, Miyata K, et al. Postcataract endophthalmitis caused by Enterococcus faecalis. Nippon Ganka Gakkai Zasshi. 2014;118:22–7 (in Japanese).
23.
Zurück zum Zitat Kitamura Y, Yoshida K, Kusama M, Sugiyama Y. A proposal of a pharmacokinetic/pharmacodynamic (PK/PD) index map for selecting an optimal PK/PD index from conventional indices (AUC/MIC, Cmax/MIC, and TAM) for antibiotics. Drug Metab Pharmacokinet. 2014;29:455–62.CrossRef Kitamura Y, Yoshida K, Kusama M, Sugiyama Y. A proposal of a pharmacokinetic/pharmacodynamic (PK/PD) index map for selecting an optimal PK/PD index from conventional indices (AUC/MIC, Cmax/MIC, and TAM) for antibiotics. Drug Metab Pharmacokinet. 2014;29:455–62.CrossRef
24.
Zurück zum Zitat Akpek EK, Vittitow J, Verhoeven RS, Brubaker K, Amar T, Powell KD, et al. Ocular surface distribution and pharmacokinetics of a novel ophthalmic 1% azithromycin formulation. J Ocul Pharmacol Ther. 2009;25:433–9.CrossRef Akpek EK, Vittitow J, Verhoeven RS, Brubaker K, Amar T, Powell KD, et al. Ocular surface distribution and pharmacokinetics of a novel ophthalmic 1% azithromycin formulation. J Ocul Pharmacol Ther. 2009;25:433–9.CrossRef
Metadaten
Titel
Analysis of treatment protocols using azithromycin eye drops for bacterial blepharitis: second report—bacteriological investigation
verfasst von
Ryohei Nejima
Hiroshi Eguchi
Daisuke Todokoro
Tomoyuki Inoue
Yuichi Kaji
Takashi Suzuki
Takaaki Hattori
Saichi Hoshi
Yumi Sasaki
Yoshitsugu Inoue
Publikationsdatum
01.10.2022
Verlag
Springer Japan
Erschienen in
Japanese Journal of Ophthalmology / Ausgabe 6/2022
Print ISSN: 0021-5155
Elektronische ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-022-00947-8

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