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69 EW RESIDENTS January 2017 12. Tou N, et al. Clinical utility of antimicrobial susceptibility measurement plate covering formulated concentrations of various oph- thalmic antimicrobial drugs. Clin Ophthalmol. 2016;10:2251–2257. Contact information Sun: grs2003@med.cornell.edu to ophthalmic application. Many articles that investigate antibiot- ic resistance of ocular flora use the Kirby-Bauer antibiotic testing technique, which utilizes drug concentrations that are much lower than those achieved with topical antibiotic use. In the present study, Nejima et al. used the SG17 plates from Eiken Chemical, Tokyo, Japan, which are antimicrobial susceptibil- ity measurement plates specific for ophthalmic utilization with con- centrations that are more clinically relevant. 12 A question that arose on our review of the article was whether inclusion of the contralateral eye would be useful. This would provide an internal control to compare alter- ations in conjunctival flora and drug resistance of the fellow eye. This information may be clinically useful as many ophthalmologists perform cataract surgery on the contralat- eral eye within the 3-month peri- od during which the study shows persistent alteration in conjunctival flora. In conclusion, the article "An investigation of the effect of the administration period with perioper- ative topical levofloxacin on normal conjunctival bacterial flora" provides useful information that may help direct ophthalmologists' practice patterns with regard to topical perioperative antibiotic use. By looking at drug MIC and bacterial susceptibility testing, the study sup- ports limited duration of periopera- tive antibiotics after cataract surgery to prevent the emergence of antibi- otic resistance. EW References 1. Jabbarvand M, et al. Endophthalmitis occur- ring after cataract surgery: Outcomes of more than 480,000 cataract surgeries, epidemiolog- ic features, and risk factors. Ophthalmology. 2016;123:295–301. 2. Callegan MC, et al. Bacterial endophthalmi- tis: epidemiology, therapeutics, and bacte- rium-host interactions. Clin Microbiol Rev. 2002;15:111–124. 3. Mino de Kaspar H, et al. Antibiotic suscepti- bility of preoperative normal conjunctival bac- teria. Am J Ophthalmol. 2005;139:730–733. 4. Keshav BR, et al. Normal conjunctival flora and their antibiotic sensitivity in Omanis undergoing cataract surgery. Oman J Ophthalmol. 2012;5:16–18. 5. Arantes TE, et al. Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery. Arq Bras Oftalmol. 2006;69:33–36. 6. Mino de Kaspar H, et al. A prospective randomized study to determine the efficacy of preoperative topical levofloxacin in reducing conjunctival bacterial flora. Am J Ophthalmol. 2008;145:136–142. 7. Chang DF, et al. Antibiotic prophylaxis of postoperative endophthalmitis after cata- ract surgery: Results of the 2014 ASCRS member survey. J Cataract Refract Surg. 2015;41:1300–1305. 8. Kim SJ, et al. Ophthalmic antibiotics and antimicrobial resistance a randomized, con- trolled study of patients undergoing intravitre- al injections. Ophthalmology. 2011;118:1358– 1363. 9. Miller D, et al. In vitro fluoroquinolone resis- tance in staphylococcal endophthalmitis iso- lates. Arch Ophthalmol. 2006;124:479–483. 10. Ta CN, et al. Antibiotic resistance patterns of ocular bacterial flora: A prospective study of patients undergoing anterior segment surgery. Ophthalmology. 2003;110:1946–1951. 11. Oshika T, et al. Incidence of endophthal- mitis after cataract surgery in Japan. Acta Ophthalmol Scand. 2007;85:848–851. CorneaCongress.org/2020 For Information & Updates

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