Is Antibiotic Resistance a Problem in the Treatment of Ophthalmic Infections?

Regis P Kowalski


Expert Rev Ophthalmol. 2013;8(2):119-126. 

In This Article

Expert Commentary & Five-year View

Little change will be realized in the anti-infective treatment of bacterial ocular infections in the next 5 years because of the lack of necessity. Ocular antibiotics are generally an extension of systemic antibiotics which are already tested for toxicity and tissue penetration efficacy. Most of the antibiotic development for systemic therapy is for the treatment of Gram-positive infections such as MRSA and vancomycin-resistant Enterococcus. In ophthalmology, the interest is not with narrow-spectrum Gram-positive antibiotics, but with broad-spectrum anti-infectives such as the fluoroquinolones. The development of Gram-positive antibiotics such as linezolid, daptomycin and tigecycline could be warranted if ocular MRSA infection becomes a future problem. The development of a novel topical antimicrobial drug with broad-spectrum antibacterial activity and antiviral activity toward adenovirus and possibly Herpes simplex should be a future objective. A compound with this capability along with a potential to combat fungus and Acanthamoeba would also be advantageous. The next 5 years should also involve the development of new compounds for enhancing present antibiotic therapy to inhibit biofilms that can possibly exasperate ocular infection.