Comparison of Topical Gatifloxacin and Levofloxacin at Different Durations in Eliminating Conjunctival Bacterial Flora

Purpose: To compare the efficacy of topical levofloxacin and gatifloxacin at different durations in reducing conjunctival bacteria. Methods: In total, 285 patients (290 eyes) scheduled to undergo ophthalmic surgery were divided into 6 groups to receive either gatifloxacin or levofloxacin eye drops for 1 day (12 times/day), 2 days (6 times/day), or 3 days (4 times/day) before surgery. Conjunctival sac specimens were collected from all patients before treatment (T0) and after treatment (T1). All specimens were inoculated onto Columbia blood agar plates. Results: Before treatment, the culture positivity rate was 50.34% for 290 samples, and after treatment, the culture positivity rate was 11.72% (P < 0.05). Corynebacterium spp. and Staphylococcus spp. were the most predominantly detected microbial groups before and after treatment. The bacterial eradication rate was higher in the gatifloxacin group (87.01%) than in the levofloxacin group (81.15%). There was no difference in culture positivity between gatifloxacin 1-, 2-, and 3-day groups (P > 0.05). The culture positivity rate was significantly higher in the levofloxacin 1-day group than in the 2- and 3-day groups (P < 0.05). Both drugs were effective in removing gram-positive bacillus at different durations (P < 0.01), but only the levofloxacin treatment for 3 days significantly reduced the positive cultures of gram-positive cocci in the conjunctival sac (P < 0.05). Conclusions: Our study demonstrated that preoperative use of levofloxacin to prevent infection takes at least 2-3 days, and 1 day is a sufficient duration for topical gatifloxacin to significantly reduce conjunctival bacterial flora.