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Besifloxacin in the management of bacterial infections of the ocular surface

      Abstract

      Acute bacterial conjunctivitis is a common infection of the ocular surface. Increasing rates of bacterial resistance have prompted the development of new antibiotics with improved activity against the bacterial species most often found in this disease. Besifloxacin is the first topical chlorofluoroquinolone developed solely for ophthalmic use. Studies have attested to its in vitro potency against a broad range of bacteria, as well as its efficacy in clinical studies of bacterial conjunctivitis when dosed 2 or 3 times a day. This review provides an up-to-date summary of studies on causative pathogens in acute bacterial conjunctivitis; recent geographic trends in bacterial resistance among ocular pathogens, including that of methicillin-resistant Staphylococcus aureus; the efficacy of besifloxacin in preclinical and clinical studies; its safety; and the role of besifloxacin in combating resistant strains. Further, this review provides a brief update on bacterial keratitis, causative pathogens, the development of resistance among those pathogens, and the potential role of besifloxacin in the treatment of bacterial keratitis.

      Résumé

      La conjonctivite bactérienne aiguë est une infection courante de la surface oculaire. Face à la résistance croissante des bactéries, on a mis au point de nouveaux antibiotiques plus efficaces contre les espèces bactériennes le plus souvent à l’origine de l’infection. La bésifloxacine est la première chloro-fluoroquinolone topique conçue exclusivement pour usage ophtalmique. Des études ont attesté son action in vitro contre un large éventail de bactéries, et des études cliniques sur la conjonctivite bactérienne ont aussi démontré son efficacité lorsqu’elle était administrée de 2 à 3 fois par jour. Cette revue fournit une synthèse à jour sur : des études ayant porté sur des agents pathogènes responsables de la conjonctivite bactérienne aiguë; les tendances géographiques récentes de la résistance d’agents pathogènes oculaires, dont le staphylocoque doré résistant à la méthicilline; l’efficacité de la bésifloxacine mesurée dans des études précliniques et cliniques; son innocuité; et le rôle de la bésifloxacine dans la lutte contre des souches résistantes. La revue fait aussi brièvement le point sur la kératite bactérienne, les agents pathogènes qui en sont responsables, le développement de la résistance de ces agents et le rôle que pourrait jouer la bésifloxacine dans le traitement de la kératite bactérienne.
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