minocycline and Keratitis

The goals of the current study were to determine the in vitro antibacterial activity of tigecycline against multiple clinically relevant ocular pathogens and to evaluate the in vivo ocular tolerability and efficacy of 0.5% tigecycline in a methicillin-resistant Staphylococcus aureus (MRSA) keratitis model.. In vitro: Minimum inhibitory concentrations (MICs) were determined for 110 clinical conjunctivitis isolates, 26 keratitis isolates of Pseudomonas aeruginosa, and 10 endophthalmitis isolates each of MRSA, methicillin-susceptible S. aureus (MSSA), MR, and MS coagulase-negative Staphylococcus.. Six uninfected rabbits were topically treated in both eyes with 0.5% tigecycline, vehicle, or saline every 15 min for 3 h.. Thirty-two rabbits were intrastromally injected with 700 Colony Forming Units (CFU) of MRSA in both eyes and were separated into 4 groups (n = 8): tigecycline 0.5%; vancomycin 5%; saline; and no treatment (euthanized before treatment for baseline CFU). Four hours after MRSA challenge, topical treatment of 1 drop every 15 min for 5 h was initiated. One hour after treatment, the corneas were harvested for CFU. The data were analyzed nonparametrically.. In vitro: Tigecycline demonstrated lower MICs than the other tested antibiotics against gram-positive organisms, especially MRSA, while MICs against gram-negative pathogens, including fluoroquinolone-resistant P. aeruginosa, appeared to be in the treatable range with aggressive topical therapy.. 0.5% tigecycline was graded as minimally irritating.. 0.5% tigecycline and vancomycin produced similar reductions in CFU and were less than saline (P < 0.05). Tigecycline and vancomycin demonstrated 99.9% reductions compared with baseline CFU.. Tigecycline is a potential candidate for a topical ocular antibiotic.

Topics: Administration, Ophthalmic; Animals; Anti-Bacterial Agents; Eye Infections, Bacterial; Female; In Vitro Techniques; Keratitis; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Minocycline; Rabbits; Staphylococcal Infections; Tigecycline

The aim of the present study was to evaluate the effectiveness of topically applied tigecycline for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) in a rabbit model.. Experimental bacterial keratitis was induced in rabbits by a corneal intrastromal injection of 100 colony-forming units (CFUs) of MRSA bacteria. Sixteen hours after the injection, 28 rabbits were randomly divided into 4 treatment groups of 7 rabbits each. In each group, the rabbits' eyes were treated topically with 19 doses of topical tigecycline (10 or 50 mg/mL), vancomycin (50 mg/mL), or isotonic saline. Slit lamp examinations were performed before and after the inoculation by two observers masked to the study for the determination of clinical severity. Corneas were harvested for bacterial quantitation and histopathologic examination.. No significant differences were observed in the clinical scores between pretreatment and posttreatment in the 4 groups (P>0.05). The mean difference between the pretreatment and posttreatment clinical scores from the 4 treatment groups was also not significant (P>0.05). All treatment groups had significantly lower CFUs compared with the control group. There were no significant differences in the bacterial load among the treatment groups. The minimum inhibitory concentration (MIC) for tigecycline was 0.12 μg/mL, whereas the MIC for vancomycin was 2.2 μg/mL. The tigecycline 10 mg/mL group had the lowest mean epithelial erosion values among the treatment groups.. Topical tigecycline significantly reduced the bacterial load in infected rabbit corneas and may be as effective as vancomycin for the topical treatment of MRSA keratitis.

Topics: Animals; Disease Models, Animal; Eye Infections, Bacterial; Keratitis; Methicillin-Resistant Staphylococcus aureus; Minocycline; Rabbits; Random Allocation; Tigecycline

To report a case of phthisis bulbi resulting from late congenital syphilis untreated until adulthood.. Observational case report.. We report clinical and laboratory evaluations of a 43-year-old woman who presented with a palpebral ulcer of the right eye.. The patient had a gummatous palpebral ulcer and a phthisis bulbi in the right eye and a gumma on the left eyelid. A silent interstitial keratitis of the left eye was detected. The patient had hearing loss in the right ear, her nose was missing, and her right leg had been amputated. Treponemal pallidum hemagglutination (TPHA) test was positive. Although we administered intensive oral penicillin, the clinical symptoms of the patient did not improve.. This is a rare case of phthisis bulbi resulting from late congenital syphilis. We emphasize that treatment for late congenital syphilis must be carried out early and completely.

Topics: Adult; Amoxicillin; Anti-Bacterial Agents; Drug Therapy, Combination; Eyelid Diseases; Female; Glucocorticoids; Hemagglutination Tests; Humans; Keratitis; Minocycline; Syphilis Serodiagnosis; Syphilis, Congenital; Ulcer

Clarithromycin, a macrolide antibiotic not previously tested against the common causes of bacterial keratitis, was analyzed for its effectiveness in reducing the number of viable bacteria in a Staphylococcus keratitis model. An in vivo comparison of the effectiveness of clarithromycin to erythromycin, minocycline, and tetracycline for three strains of Staphylococcus aureus was done.. Rabbit eyes were intrastromally injected with 100 colony forming units of one of three strains of S. aureus. Two strains were methicillin-sensitive (ATCC 25923 and MSSA 309) and one strain methicillin-resistant (COL). Eyes were treated every 30 minutes with 0.3% clarithromycin, erythromycin, tetracycline, or minocycline from 4 to 9 hours postinfection. The number of colony forming units (CFU) per cornea in all eyes was determined at 10 hours postinfection.. Vehicle-treated and untreated eyes (controls) contained over 6 logs of CFU per cornea, a value significantly higher than any of the antibiotic-treated eyes (P < or = 0.0001). Clarithromycin or erythromycin therapy significantly decreased the number of CFU per cornea by approximately 5 logs in the eyes infected with the methicillin-sensitive strains and by approximately 4 logs in the eyes infected with the methicillin-resistant strain. Tetracycline and minocycline were also successful in treating these strains, but overall showed less effectiveness than clarithromycin and erythromycin.. Clarithromycin proved to be an effective ocular medication for the therapy of experimental S. aureus keratitis. The effectiveness of clarithromycin in this model and its known effectiveness for a variety of bacterial pathogens suggests a role for this drug as a useful ocular antibiotic.

Topics: Animals; Anti-Bacterial Agents; Clarithromycin; Colony Count, Microbial; Erythromycin; Keratitis; Minocycline; Rabbits; Staphylococcal Infections; Staphylococcus aureus; Tetracycline

Cogan's syndrome is a rare clinical entity defined by the association of a nonsyphilitic interstitial keratitis and vestibuloauditory dysfunction, typically Menière's disease-like; the condition has been reported in association with a variety of cutaneous diseases. We now report a case of pyoderma gangrenosum complicating Cogan's syndrome in a 57-year-old woman, which then healed dramatically, as more interestingly did the associated uveitis with minocycline therapy.

Topics: Ataxia; Deafness; Female; Humans; Keratitis; Meniere Disease; Middle Aged; Minocycline; Nausea; Pyoderma Gangrenosum; Syndrome; Uveitis; Vertigo; Vomiting

A 35-year-old woman presented with a bilateral palpebral follicular conjunctivitis. Subsequently, she developed a bilateral keratitis and, on a separate occasion, an episcleritis that was associated with a recrudescence of Lyme disease and poor compliance with the antibiotic regimen. Both the keratitis and episcleritis cleared completely after topical corticosteroid therapy and reinstitution of appropriate antibiotic treatment. This report emphasizes the importance of collaboration between internal medicine and ophthalmologic specialists during the long-term management of Lyme disease.

Topics: Adrenal Cortex Hormones; Adult; Borrelia burgdorferi Group; Conjunctivitis; Female; Fluorescent Antibody Technique; Humans; Keratitis; Lyme Disease; Minocycline; Scleritis

Topics: Adult; Corneal Transplantation; Ethambutol; Eye Injuries; Humans; Keratitis; Male; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Rifampin; Scleral Diseases; Skin Tests