Ophthalmologic Manifestations of Escherichia Coli Medication
- Author: Donny W Suh, MD, FAAP; Chief Editor: Hampton Roy, Sr, MD more...
The goals of pharmacotherapy are to eradicate the E coli infection, to reduce morbidity, and to prevent complications.
Therapy must be comprehensive and cover all likely pathogens in the context of this clinical setting.
Inhibits bacterial growth by inhibiting DNA gyrase. Indicated for superficial ocular infections of the conjunctiva or cornea caused by strains of microorganisms susceptible to ciprofloxacin.
Pyridine carboxylic acid derivative with broad-spectrum bactericidal effect. Inhibits bacterial growth by inhibiting DNA gyrase. Indicated for superficial ocular infections of the conjunctiva or cornea caused by strains of microorganisms susceptible to ofloxacin.
Interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, which results in a defective bacterial cell membrane. Available as a solution, ointment, and lotion.
Aminoglycoside antibiotic used for gram-negative bacterial coverage.
First-generation cephalosporin antibiotic for gram-positive bacterial coverage. Commonly used in combination with an aminoglycoside to achieve broad spectrum. This 50-133 mg/mL solution must be compounded.
Potent antibiotic directed against gram-positive organisms and active against Enterococcus species. Useful in the treatment of septicemia and skin structure infections. Indicated for patients who cannot receive, or have failed to respond to penicillins and cephalosporins or have infections with resistant staphylococci. For abdominal penetrating injuries, it is combined with an agent active against enteric flora and/or anaerobes.
To avoid toxicity, current recommendation is to assay vancomycin trough levels after third dose drawn 0.5 h prior to next dosing. Use creatinine clearance to adjust dose in patients diagnosed with renal impairment.
Used in conjunction with gentamicin for prophylaxis in patients with penicillin allergy undergoing GI or genitourinary procedures.
Fourth-generation fluoroquinolone ophthalmic indicated for bacterial conjunctivitis. Elicits a dual mechanism of action by possessing an 8-methoxy group, thereby inhibiting the enzymes DNA gyrase and topoisomerase IV. DNA gyrase is involved in bacterial DNA replication, transcription, and repair. Topoisomerase IV is essential in chromosomal DNA partitioning during bacterial cell division.
S-enantiomer of ofloxacin. Inhibits DNA gyrase in susceptible organisms, thereby inhibiting relaxation of supercoiled DNA and promoting breakage of DNA strands.
Indicated to treat bacterial conjunctivitis. Elicits antimicrobial effects. Inhibits topoisomerase II (DNA gyrase) and IV enzymes. DNA gyrase is essential in bacterial DNA replication, transcription, and repair. Topoisomerase IV plays a key role in chromosomal DNA portioning during bacterial cell division.
Instillation of a long-acting cycloplegic agent can relax any ciliary muscle spasm that can cause a deep aching pain and photophobia.
Blocks the action of acetylcholine at parasympathetic sites in the smooth muscle, producing pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia).
These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.
Treats acute inflammations following eye surgery or other types of insults to eye. Decreases inflammation and corneal neovascularization. Suppresses migration of polymorphonuclear leukocytes and reverses increased capillary permeability. In cases of bacterial infections, concomitant use of anti-infective agents is mandatory; if signs and symptoms do not improve after 2 days, reevaluate patient. Dosing may be reduced, but advise patients not to discontinue therapy prematurely.
Chen CJ, Starr CE. Epidemiology of gram-negative conjunctivitis in neonatal intensive care unit patients. Am J Ophthalmol. 2008 Jun. 145(6):966-970. [Medline].
Raju B, Bali T, Thiagarajan G, Rao V, Das T, Sharma S. Physicochemical properties and antibacterial activity of the precipitate of vancomycin and ceftazidime: implications in the management of endophthalmitis. Retina. 2008 Feb. 28(2):320-5. [Medline].
Amini E, Ghasemi M, Daneshjou K. A five-year study in Iran of ophthalmia neonatorum: prevalence and etiology. Med Sci Monit. 2008 Feb. 14(2):CR90-96. [Medline].
Aronson SB, Elliott JH. Ocular Inflammation. St. Louis, MO: CV Mosby; 1972. 103-5, 112-4.
Balestrazzi A, Blasi MA, Primitivo S, Balestrazzi E. Escherichia coli endophthalmitis after trans-scleral resection of uveal melanoma. Eur J Ophthalmol. 2002 Sep-Oct. 12(5):437-9. [Medline].
Bonadio WA, Smith DS, Madagame E, et al. Escherichia coli bacteremia in children. A review of 91 cases in 10 years. Am J Dis Child. 1991 Jun. 145(6):671-4. [Medline].
Charoo NA, Kohli K, Ali A, Anwer A. Ophthalmic delivery of ciprofloxacin hydrochloride from different polymer formulations: in vitro and in vivo studies. Drug Dev Ind Pharm. 2003 Feb. 29(2):215-21. [Medline].
Cordido M, Fernandez-Vigo J, Cordido F, Rey AD. Bilateral metastatic endophthalmitis in diabetics. Acta Ophthalmol (Copenh). 1991 Apr. 69(2):266-7. [Medline].
Eisenstein BI. Escherichia coli infections. Harrison's Principles of Internal Medicine. 1994. 661-3.
Epstein SP, Bottone EJ, Asbell PA. Susceptibility testing of clinical isolates of pseudomonas aeruginosa to levofloxacin, moxifloxacin, and gatifloxacin as a guide to treating pseudomonas ocular infections. Eye Contact Lens. 2006 Sep. 32(5):240-4. [Medline].
Fanning WL, Stubbert J, Irwin ES, Aronson MD. A case of bilateral Escherichia coli endogenous endophthalmitis. Am J Med. 1976 Aug. 61(2):295-7. [Medline].
Faraawi R, Fong IW. Escherichia coli emphysematous endophthalmitis and pyelonephritis. Case report and review of the literature. Am J Med. 1988 Mar. 84(3 Pt 2):636-9. [Medline].
Glasser DB, Baum J. Antibacterial agents. Infections of the Eye. 1996. 207-30.
Hyndiuk RA, Cokington CD. Bacterial keratitis. Infections of the Eye. 1996. 323-47.
Katz HR. A retrospective study of endophthalmitis rates comparing quinolone antibiotics. Am J Ophthalmol. 2005 Oct. 140(4):771-2; author reply 772-3. [Medline].
Ko KS, Lee MY, Song JH, et al. Prevalence and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated in Korean hospitals. Diagn Microbiol Infect Dis. 2008 Aug. 61(4):453-9. [Medline].
Munoz Morente A, Baron Ramos MA, Mateos Fernandez S, Reguera Iglesias JM. Endogenous bacterial endophthalmitis: a case report and brief review [in Spanish]. An Med Interna. 2004 Dec. 21(12):597-8. [Medline].
Park SB, Searl SS, Aquavella JV, Erdey RA. Endogenous endophthalmitis caused by Escherichia coli. Ann Ophthalmol. 1993 Mar. 25(3):95-9. [Medline].
Regnier A, Schneider M, Concordet D, Toutain PL. Intraocular pharmacokinetics of intravenously administered marbofloxacin in rabbits with experimentally induced acute endophthalmitis. Am J Vet Res. 2008 Mar. 69(3):410-5. [Medline].
Sanford JP, Gilbert DN, Sande MA. Antimicrobial. Guide to Antimicrobial Therapy. 1997. 47.
Sekimoto M, Hayasaka S, Setogawa T, Shigeno K. Endogenous Escherichia coli endophthalmitis in a patient with autosomal-dominant polycystic kidney disease. Ann Ophthalmol. 1991 Dec. 23(12):458-9. [Medline].
Shammas HF. Endogenous E. coli endophthalmitis. Surv Ophthalmol. 1977 Mar-Apr. 21(5):429-35. [Medline].
Sim DA, Feasey N, Wren S, Breathnach A, Thompson G. Cross-infection risk of felt-tipped marker pens in cataract surgery. Eye. 2008 Jul 11. [Medline].
Starr MB. A retrospective study of endophthalmitis rates comparing quinolone antibiotics. Am J Ophthalmol. 2005 Oct. 140(4):769-70; author reply 770-1. [Medline].
Sunakawa K, Nonoyama M, Ooishi T, et al. The trend of childhood bacterial meningitis in Japan (2000-2002) [in Japanese]. Kansenshogaku Zasshi. 2004 Oct. 78(10):879-90. [Medline].
Tseng CY, Liu PY, Shi ZY, et al. Endogenous endophthalmitis due to Escherichia coli: case report and review. Clin Infect Dis. 1996 Jun. 22(6):1107-8. [Medline].
Turck M, Schaberg D. Infections due to enterobacteriaceae. Harrison's Principles of Internal Medicine. 1980. 629-34.
Walmsley RS, David DB, Allan RN, Kirkby GR. Bilateral endogenous Escherichia coli endophthalmitis: a devastating complication in an insulin-dependent diabetic. Postgrad Med J. 1996 Jun. 72(848):361-3. [Medline].
Wann SR, Liu YC, Yen MY, et al. Endogenous Escherichia coli endophthalmitis. J Formos Med Assoc. 1996 Jan. 95(1):56-60. [Medline].
Zhang YQ, Wang WJ. Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina. 2005 Sep. 25(6):746-50. [Medline].