cefmenoxime and Corneal-Ulcer

Moraxella species are rare causative pathogens of severe sight-threatening keratitis. The aim of this study was to analyze the clinical presentation, predisposing risk factors, in vitro antimicrobial susceptibility, and treatment associated with Moraxella keratitis.. We retrospectively reviewed 30 culture-proven cases of Moraxella keratitis from multiple centers in Japan.. The mean age of the patients was 58.4 ± 23.4 years. The most common ocular conditions were contact lens wearing (5 patients, 16.7%) and trauma (3 patients, 10.0%). Seven patients had diabetes mellitus. Sixteen patients exhibited hypopyon in association with the corneal focus. Ring-shaped infiltration was found in 9 patients (30.0%), and irregular or amoebic-shaped infiltration was observed in 13 patients (43.3%). Eight patients (26.7%) showed small round infiltrates. All Moraxella isolates were sensitive to fluoroquinolones and aminoglycosides. All were treated with a combination ophthalmic solution containing a fluoroquinolone, tobramycin, and cefmenoxime. Although no patients developed corneal perforation, the response to treatment was slow in all cases; the mean treatment period was 41.9 days.. In Japan, Moraxella keratitis occurs in patients with contact lens wear, trauma, and diabetes mellitus. It presents as a small, round, ring-shaped, irregularly shaped, or amoebic-shaped focus. Moraxella species exhibit good susceptibility to fluoroquinolones and aminoglycosides. Because the treatment response may be very slow, these agents should be continued for a long period of time.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cefmenoxime; Child; Contact Lenses; Corneal Ulcer; Drug Therapy, Combination; Eye Infections, Bacterial; Eye Injuries; Female; Fluoroquinolones; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Moraxella; Moraxellaceae Infections; Retrospective Studies; Risk Factors; Tobramycin

To study the in vitro interaction of fluoroquinolones such as levofloxacin (LVFX), gatifloxacin (GFLX), or moxifloxacin (MFLX) in combination with tobramycin (TOB) or cefmenoxime (CMX) against clinical isolates of bacteria from keratitis.. The activity of each drug alone was determined by an agar dilution method. Checkerboard synergy testing was then performed against 47 isolates, including Staphylococcus species, Streptococcus species, and Pseudomonas aeruginosa. Antimicrobial combinations were classified as synergistic, additive, indifferent, or antagonistic, according to their fractional inhibitory concentration.. The average fractional inhibitory concentration indexes of combined use of LVFX/CMX or GFLX/CMX in Staphylococcus species and Streptococcus species, and LVFX/CMX, GFLX/CMX, MFLX/CMX in gram-negative rods were low. The additive activity of the following drug combinations were seen in more than 70% of isolates: LVFX/CMX and GFLX/CMX against gram-positive cocci and LVFX/CMX, GFLX/CMX, MFLX/CMX against gram-negative rods. No consistent synergistic or antagonistic effect was observed with the combinations used.. The combination of LVFX/CMX or GFLX/CMX was predominantly additive for all tested isolates.

Topics: Anti-Bacterial Agents; Aza Compounds; Bacteria; Cefmenoxime; Corneal Ulcer; Drug Combinations; Drug Synergism; Eye Infections, Bacterial; Fluoroquinolones; Gatifloxacin; Humans; Levofloxacin; Microbial Sensitivity Tests; Moxifloxacin; Pseudomonas; Quinolines; Staphylococcus; Streptococcus; Tobramycin

To describe a Pseudomonas aeruginosa corneal infection resulting from orthokeratology.. Case report.. A 17-year-old boy wearing orthokeratology (OK) lenses was referred to our clinic because of redness in his right eye in spite of his usage of ofloxacin (OFLX) eye drops. An excavated paracentral corneal ulcer with an immune ring and hypopyon was observed. It was positioned under the paracentral steeper portion of the optic of the OK lens. Culture of the lens solution revealed P. aeruginosa. The patient was treated with topical OFLX and cefmenoxime (CMX) plus intravenous and subconjunctival injections of cefozopran (CZOP), successfully. The antibiotic susceptibility of P. aeruginosa by the disk diffusion susceptibility test was reduced under moderately hypoxic conditions. Glycocalyx slime was formed on the OK lens in vitro by P. aeruginosa isolated from the case.. Changes in P. aeruginosa susceptibility to antibiotics under moderately hypoxic conditions and glycocalyx slime formation might affect the features of OK lens-associated infections.

Topics: Administration, Topical; Adolescent; Anti-Bacterial Agents; Cefmenoxime; Cefozopran; Cephalosporins; Contact Lenses; Corneal Ulcer; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Infusions, Intravenous; Male; Microbial Sensitivity Tests; Ofloxacin; Pseudomonas aeruginosa; Pseudomonas Infections