Effects of Long Term Use of Prostaglandin Analogues with
and Without Preservative on Normal Conjunctival Flora of
Glaucoma Patients
Volume 2 - Issue 5
Rupankar Sarkar1*, Humayoun Ashraf1, Syed Wajahat Ali Rizvi1 and Sameer Ashraf2
- 1Institute of Ophthalmology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University (AMU), Aligarh, India
- 2Ratanjyoti netralaya & Apollo hospital, India
Received:April 12, 2020; Published:April 23, 2020
Corresponding author: Rupankar Sarkar, Institute of Ophthalmology, JN Medical College, AMU., Aligarh, India
DOI: 10.32474/TOOAJ.2020.02.000150
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Abstract
Purpose: The effects of long term use of Benzalkonium chloride-preserved prostaglandin analogue eye drop on conjunctival
bacterial flora was investigated and compared with preservative-free prostaglandin analogue eye drop
Methods: Conjunctival swabs were collected from 48 patients of glaucoma who had instilled either BAK-preserved latanoprost
or preservative-free travoprost eye drops for 1 year. The bacterial characteristics and sensitivity patterns of the bacterial isolates
from the conjunctival swabs of the two groups were compared between each other and also with conjunctival bacterial flora from
normal healthy controls.
Results: There was no significant difference in culture positivity among the three groups (p = 0.99). 100% (13/13) isolates
from Latanoprost group were Gram positive organisms. In the Travoprost group, 12 out of 14 isolates (85.7%) from 13 eyes were
gram positive while the rest 2 bacteria (14.3%) were gram negative. In Controls, 14 out of 16 (87.5%) isolates were gram positive
and the rest were gram negative. Methicillin-resistance was seen in 72.7% (8/11) of the CONS isolated from Latanoprost group,
while 45.5% (5/11) of the CONS isolated from preservative free travoprost group were Methicillin resistant. While in the controls
45.4% (5/11) of the isolated CONS were Methicillin resistant. The occurrence of Methicillin resistant CONS (MR CONS) was higher
in latanoprost group than the other two groups, though not statistically significant. Resistance to commonly used antibiotics was
comparatively higher in BAK-preserved latanoprost group. Not a single gram positive bacteria was resistant to Vancomycin
Conclusion: Long-term use of prostaglandin analogues for glaucoma may adversely affect the antibiotic-resistance of indigenous
bacterial flora of the eye by increasing the resistance against common antibiotics including Methicillin resistance.
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