THE ROLE OF CIPROFLOXACIN IN ENDOPHTHALMITIS THERAPY

Ciprofloxacin has been proposed for the systemic treatment of endophth almitis. We studied the role of therapy based on the susceptibility of actual bacterial isolates and developed a system for assessing this s usceptibility in endophthalmitis. Susceptibility testing was performed on 68 bacterial isolates from 66 patients with endophthalmitis. Our r esults indicated that, on the basis of a vitreous ciprofloxacin concen tration of 0.25 mu g/ml, only 41 of 68 isolates (60%) would be inhibit ed by systemic therapy. All gram-negative bacteria (six of six) would be inhibited, whereas gram-positive bacterial susceptibility was varia ble. We concluded that systemic ciprofloxacin alone should not be admi nistered empirically but it could provide an adjunct for treating sele ctive cases of bacterial endophthalmitis. Bacterial susceptibility sho uld be assessed on a blood serum standard of 0.25 mu g/ml instead of 1 .0 mu g/ml.