DEC 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/99908

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Page 17 of 72

December 2012 Pharmaceutical focus Antibiotics on the edge Dry Eye Lid Squeezers n by Maxine Lipner Senior EyeWorld Contributing Writer m ibu Me s er oll R d se lo C * or ss re p Ex Fo rc ep s* * n��� ki as M 6: 71 01 8- m bu ei M Ey el id 7: H ar dt en 801 71 I t happens every day in an ophthalmologist���s office. A patient presents with a corneal ulcer resulting from microbial keratitis and is prescribed a broadspectrum fluoroquinolone. The fact is, however, nearly all of these medications are being used off-label in this scenario. In actuality, none of the newest agents have FDA approval for corneal ulcer use, according to Vincent P. de Luise, M.D., assistant clinical professor of oph- thalmology, Yale University School of Medicine, New Haven, Conn. ���The fourth-generation fluoroquinolones have an FDA label for use in bacterial conjunctivitis, not for microbial keratitis,��� he said. Still, they are the go-to drugs here, with the majority of practitioners readily turning to them, with few exceptions, he finds. The determination not to pursue labeling for corneal ulcers was a practical move by the companies, which found it quite costly to tackle FDA clearance for this relatively small market. ���The companies never went back to test their fluoroquinolones against bacte- C om pr es si on Corneal ulcer Battling corneal ulcers off-label with broadspectrum ���uoroquinolones E io ss re xp Meibum Expression Is Recommended As A Subsequent Procedure To Meibomian Gland Probing, Insuring The Patency Of Meibomian Glands. Call 800-637-4346 For More Information. Or Visit www.RheinMedical.com continued on page 16 When continued from page 14 versa. Over the dinner table, what story are you going to tell your spouse? What is going to stick with you the next day? The blind lady missing her daughter���s wedding, of course! The issue with the most emotional pull is always the one with a vivid anecdote, not the issue with impressive, but bland, data. I���m not saying this is a good thing, but that is what gets remembered, and human nature being what it is, that���s the squeaky wheel that will get the grease. EW 3360 Scherer Drive, Suite B, St. Petersburg, FL 33716 s 4EL s &AX %MAIL )NFO 2HEIN-EDICALCOM s 7EBSITE WWW2HEIN-EDICALCOM $EVELOPED )N #OORDINATION 7ITH 3TEVEN , -ASKIN -$ $EVELOPED )N #OORDINATION 7ITH $AVID 2 (ARDTEN -$ Contact information Parekh: parag2020@gmail.com 2HEIN -EDICAL 3TYLIZED %YE 1321 Rev.A BABB

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