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Japanese Journal of Ophthalmology
Erschienen in:

10.01.2022 | Forefront Review

Ocular surface flora and prophylactic antibiotics for cataract surgery in the age of antimicrobial resistance

verfasst von: Takuya Iwasaki, Ryohei Nejima, Kazunori Miyata

Erschienen in: Japanese Journal of Ophthalmology | Ausgabe 2/2022

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Abstract

According to the World Health Organization alert about the antimicrobial resistance crisis released in 2015, clinicians should strongly reconsider the prolonged use of antimicrobials. In this review, we focus on the ocular surface flora with respect to the trend of fluoroquinolone resistance, and its upset and restoration after topical administration of antimicrobials and preservatives. Even 3 weeks of topical administration of levofloxacin (LVFX) yields a selection of fluoroquinolone-resistant isolates bearing genetic changes in the ocular surface flora. One month of topical prophylactic administration of LVFX after cataract surgery induces the loss of diversity with LVFX-resistance of the ocular surface flora. Restoration of LVFX-sensitive flora occurs 6 to 9 months after the final topical administration of LVFX. The ocular surface flora recovers earlier in patients given LVFX for 1 week after the surgical procedure. These findings suggest that shorter periods of postoperative topical antibiotics are less frequently associated with persistent antimicrobial-resistant bacteria in the ocular flora. In addition, microbiologic analysis of ocular surfaces treated with a long period of eye drops containing benzalkonium chloride (BAC) showed a higher incidence of isolates resistant to methicillin and fluoroquinolones than did ocular surfaces treated with eye drops not containing BAC. To avoid the emergence of antimicrobial-resistant bacteria on the ocular surface, an urgent discussion must be held about the appropriate use of antibiotics and preservatives in the ophthalmology field.
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Metadaten
Titel
Ocular surface flora and prophylactic antibiotics for cataract surgery in the age of antimicrobial resistance
verfasst von
Takuya Iwasaki
Ryohei Nejima
Kazunori Miyata
Publikationsdatum
10.01.2022
Verlag
Springer Japan
Erschienen in
Japanese Journal of Ophthalmology / Ausgabe 2/2022
Print ISSN: 0021-5155
Elektronische ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-021-00899-5

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