Topical antibiotic reduces positive cultures in chronic blepharoconjunctivitis

Graefes Arch Clin Exp Ophthalmol. 2009;247(7):993-998.

Application of topical 0.5% levofloxacin for at least 3 days significantly reduced positive cultures in patients with chronic blepharoconjunctivitis, a study showed.

In addition, "[chronic blepharoconjunctivitis] eyes have a significantly higher number of positive cultures than eyes without [chronic blepharoconjunctivitis]," the study authors said.

The prospective randomized study included 60 patients with chronic blepharoconjunctivitis assigned to three groups of 20 patients: no antibiotic treatment, topical levofloxacin four times daily in both eyes and topical levofloxacin four times daily in both eyes with eyelid scrubs. A control group comprised 40 patients without chronic blepharoconjunctivitis.

Investigators took conjunctival cultures from both eyes at baseline and 1 day, 3 days and 7 days after treatment. Coagulase-negative Staphylococcus was the most commonly isolated bacterium in all groups at baseline.

Eight patients failed to complete the study. Of the remaining 52 patients with chronic blepharoconjunctivitis, 94% had positive thioglycolate broth cultures. Fifty-eight percent of the patients without chronic blepharoconjunctivitis had positive cultures. The difference was statistically significant (P < .0001). A minimum 1-day application of topical antibiotic markedly reduced the colonization of bacteria on the conjunctival surface, the authors said.

"Scrubbing of the eyelids did not provide further benefit compared to antibiotic treatment alone," they said.