Magazine article Drug Topics

New Quinolone Gains Approval for Bacterial Conjunctivitis

Magazine article Drug Topics

New Quinolone Gains Approval for Bacterial Conjunctivitis

Article excerpt

Bacterial conjunctivitis is a common ocular infection distinguished by redness, discharge, irritation, and sometimes lid swelling or sensitivity to light. "It's common enough that people call it 'pink eye,"' said Jimmy Bartlett, O.D.

Treated topically with antibiotics, conjunctivitis often resolves in a few days. Left alone, the infection usually runs its course after two weeks or so, according to Bartlett, a professor of optometry at the University of Alabama's school of optometry in Bigham. When asked why the infection is treated at all, he replied that acute conjunctivitis can become chronic and lead to more serious conditions.

Sulfacetamide was once the firstline treatment for bacterial conjunctivitis. However, it has been abandoned in favor of newer, more effective drugs, said Bartlett. He added that allergic reactions were quite a problem with sulfacetamide. "Although [the newer antibiotics] are pretty good," he said, "their weak point seems to be Streptococcus."

Santen Pharmaceutical is preparing to offer a solution to the problem. The company received approval to market its ophthalmic preparation of levofloxacin 0.5% (Quixin) in August. The product is indicated for treatment of bacterial conjunctivitis in patients age one and older.

"This particular one is a little bit better for gram-positive [bacteria], especially Streptococcus, ' Bartlett said. "But that's really the only benefit " In terms of dosing and other considerations, levofloxacin ranks about the same as other ophthalmic quinolones. However, he surmised that activity against Streptococcus could be a key benefit. In addition to filling the gaps in conjunctivitis treatment, he anticipated the drug may eventually do the same for more serious infections, such as bacterial corneal ulcers.

During in vitro testing, levofloxacin was effective against more than 25 organisms. However, efficacy in clinical infections has been demonstrated only against 10. Among these are Staphylococcus aureus, Haemophilus influenzae, and several strains of Streptococcus, including S. pneumoniae.

In clinical trials, levofloxacin was effective against bacterial conjunctivitis in 79% of patients. While the drug was administered for five days during these trials, package labeling recommends treatment for seven days. "The data speak for themselves in that case," said Jerry Hansen, CEO of Santen.

Levofloxacin is to be applied every two hours, while awake, for the first two days, and every four hours while awake for the remainder of the week. …

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