Fourth-generation fluoroquinolone-resistant mycobacterial keratitis after laser in situ keratomileusis.

Abstract

We report a case of mycobacterial keratitis resistant to fourth-generation fluoroquinolones after laser in situ keratomileusis (LASIK) with fourth-generation fluoroquinolone prophylaxis. While receiving moxifloxacin post LASIK, the patient was diagnosed with moxifloxacin-resistant Mycobacterium chelonae keratitis. Culture susceptibilities revealed isolates resistant to moxifloxacin and gatifloxacin, and treatment with topical amikacin and clarithromycin with oral doxycycline and clarithromycin along with flap amputation was necessary to control the infection. This case demonstrates the potential limitations in the coverage of these antibiotic agents.

• Authors: Majid Moshirfar, Jay J Meyer, Ladan Espandar
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 33 Issue 11 Pg. 1978-81 (Nov 2007) ISSN: 0886-3350 [Print] United States
• PMID: 17964409 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents
• Aza Compounds
• Fluoroquinolones
• Quinolines
• Amikacin
• Clarithromycin
• Gatifloxacin
• Doxycycline
• Moxifloxacin

Topics

• Adult
• Amikacin (therapeutic use)
• Anti-Infective Agents (therapeutic use)
• Aza Compounds (therapeutic use)
• Clarithromycin (therapeutic use)
• Corneal Ulcer (drug therapy, microbiology)
• Doxycycline (therapeutic use)
• Drug Resistance, Bacterial
• Drug Therapy, Combination
• Eye Infections, Bacterial (drug therapy, microbiology)
• Female
• Fluoroquinolones (therapeutic use)
• Gatifloxacin
• Humans
• Keratomileusis, Laser In Situ
• Microbial Sensitivity Tests
• Moxifloxacin
• Mycobacterium Infections, Nontuberculous (drug therapy, microbiology)
• Mycobacterium chelonae (drug effects, isolation & purification)
• Quinolines (therapeutic use)