Wydanie 2/2017
str. 98 - 101

Zastosowanie fluorochinolonów w leczeniu najczęstszych zakażeń powierzchni oka

The Use of Fluoroquinolones in the Treatment of the Most Common Ocular Infections

Justyna Izdebska 1,2 , Piotr A. Woźniak 3,4 , Jacek P. Szaflik 1,2

1 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik Kliniki: prof. dr hab. n. med. Jacek P. Szaflik
2 Centrum Mikrochirurgii Oka Laser, Warszawa
3 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
4 Department of Clinical Pharmacology, Medical University of Vienna

Summary: Conjunctivitis and the inflammation of the ocular surface belong to the most common reasons of the ophthalmological examination. Untreated inflammation may lead to the loss of sight. The key factor in the therapeutic management is the choice of the antibiotic agent. Fluoroquinolones are one of the most efficient and widely used groups of antibiotics in ophthalmology. They are broad-spectrum (effective for both gram-negative and gram-positive bacteria) that play an important role in the treatment of serious bacterial infections. The main representatives (in ophthalmology) of these antibiotics are levofloxacin and moxifloxacin, both with broad antibacterial spectrum against Gram negative and Gram positive bacteria. Quinolones exert their antibacterial effect by preventing bacterial DNA from unwinding and duplicating. IV generation fluoroquinolones have a wider spectrum against rare pathogens such as Streptococcus pneumoniae. In in-vivo experiments levofloxacin has lower cytotoxicity compared to moxifloxacin. The use of levofloxacin is safe and well established in literature and also indicated for children. Due to the fact that conjunctivitis is mostly self-limited and caused by the specific pathogen, the empirical treatment with broad spectrum antibiotic is recommended. Identically, small infiltrations of the cornea without the damage of the epithelial integrity are also indicated for empirical treatment. In all other cases, the treatment should begin according to antibiogram.

Słowa kluczowe: zapalenia spojówek, zapalenia rogówki, fluorochinolony, lewofloksacyna, moksyfloksacyna.

Keywords: conjunctivitis, keratitis, fluoroquinolones, levofloxacin, moxifloxacin.