Emerging antibiotic resistance in ocular infections and the role of fluoroquinolones

Resistance to antibiotic agents is becoming increasingly prevalent among ocular infections. Between 19% and 60% of Streptococcus pneumoniae and Staphylococcus aureus isolates have been shown to be resistant to macrolide antibiotic agents, penicillin, and older fluoroquinolones Although topical fluoroquinolones are considered first-line treatment of ocular infections, as much as 85% of methicillin-resistant S aureus isolates are resistant to ophthalmic fluoroquinolones, including the newer 8-methoxy fluoroquinolones, gatifloxacin and moxifloxacin Besifloxacin, an 8-chlorofluoroquinolone, has a lower minimum inhibitory concentration against multidrug-resistant staphylococcal strains than other fluoroquinolones and less selective pressure for resistance development because of the lack of a systemic counterpart In addition to the development of new antibacterial agents, antibiotic resistance in ocular infections may be reduced by following the same strategies used to minimize antimicrobial resistance in systemic infections. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. J Cataract Refract Surg 2010; 36.1588-1598 (C) 2010 ASCRS and ESCRS