Bacterial Antibiotic Resistance Is an Ongoing Issue1

The Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) Surveillance Study found that concurrent antibiotic resistance rates were highest among methicillin-resistant isolates.1 The ARMOR study is the largest and only ongoing study that monitors resistance trends among ocular pathogens of concern.*

76%

of methicillin-resistant Staphylococcus aureus (MRSA) isolates showed multidrug resistance to at least 3 additional antibiotic classes.1

74%

of methicillin-resistant coagulase-negative staphylococci (MRCoNS) isolates showed multidrug resistance to at least 3 additional antibiotic classes.1

*Gram-positive and Gram-negative pathogens monitored were:

Ocular pathogen: Staphylococcus aureus

Staphylococcus
aureus

Ocular pathogen: Coagulase-negative staphylococci (CoNS, incl.S. epidermidis)

Coagulase-negative staphylococci (CoNS, incl. S. epidermidis)

Ocular pathogen: Streptococcus pneumoniae

Streptococcus
pneumoniae

Ocular pathogen: Haemophilus influenzae

Haemophilus
influenzae

Ocular pathogen: Pseudomonas aeruginosa

Pseudomonas
aeruginosa

Study Design: Isolates were collected from 86 ocular centers, community hospitals, and university hospitals from January 1, 2009, through December 31, 2015. A total of 4,226 ocular isolates were collected (1,483 S. aureus, 1,285 CoNS, 421 S. pneumoniae, 513 H. influenzae, and 524 P. aeruginosa) and, of these, the anatomical source (conjunctiva, cornea, aqueous humor, or vitreous humor) was known for 1,956 isolates. Minimum inhibitory concentrations (MICs) were determined for 11 antibiotic classes and interpreted as susceptible, intermediate, or resistant based on available systemic breakpoints.1,2

Antibiotic Resistance Is a Nationwide Concern2,3

From numerous samples of pathogens provided from the United States, investigators evaluated resistance rates across 4 national regions

Antibiotic resistance rates across four national regions

Mean percentage resistance rates shown for each pathogen across four regions.3

WEST

Staphylococcus aureus ... 17.9%

MRSA ... 28.9%

CoNS ... 22.8%

MRCoNS ... 45.24%

Streptococcus pneumoniae ... 13%

Haemophilus influenzae ... 2.3%

Pseudomonas aeruginosa ... 13.1%

MIDWEST

Staphylococcus aureus ... 25.1%

MRSA ... 45.7%

CoNS ... 25%

MRCoNS ... 53.45%

Streptococcus pneumoniae ... 21.3%

Haemophilus influenzae ... 5%

Pseudomonas aeruginosa ... 17.4%

SOUTH

Staphylococcus aureus ... 26%

MRSA ... 50%

CoNS ... 27.1%

MRCoNS ... 51.12%

Streptococcus pneumoniae ... 16.5%

Haemophilus influenzae ... 2.6%

Pseudomonas aeruginosa ... 8.1%

NORTHEAST

Staphylococcus aureus ... 24%

MRSA ... 41%

CoNS ... 25.7%

MRCoNS ... 47.27%

Streptococcus pneumoniae ... 15.3%

Haemophilus influenzae ... 2.6%

Pseudomonas aeruginosa ... 12.2%

P values for the pathogens listed above: P<0.001 for S. aureus and MRSA, P=0.232 for CoNS, P=0.223 for MRCoNS, P=0.05 for S. pneumoniae, P=0.274 for H. influenzae, and P=0.01 for P. aeruginosa.2,3

ANOVA for regional differences.

For the analysis by geography, isolates were categorized into 4 regions based on state of origin, including West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming), Midwest (Iowa, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Ohio, South Dakota, and Wisconsin), South (Alabama, Arkansas, Florida, Georgia, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia), and Northeast (Connecticut, Delaware, Massachusetts, Maine, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont).2

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See Resistance Data

Learn about the in vitro inhibitory activity of besifloxacin against ocular bacterial pathogens.

 
 
Indication

BESIVANCE® (besifloxacin ophthalmic suspension) 0.6% is a quinolone antimicrobial indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following bacteria: Aerococcus viridans*, CDC coryneform group G, Corynebacterium pseudodiphtheriticum*, Corynebacterium striatum*, Haemophilus influenzae, Moraxella catarrhalis*, Moraxella lacunata*, Pseudomonas aeruginosa*, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis*, Staphylococcus lugdunensis*, Staphylococcus warneri*, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae, Streptococcus salivarius*

*Efficacy for this organism was studied in fewer than 10 infections.

Important Safety Information
  • BESIVANCE is not for injection into the eye.
  • As with other anti-infectives, prolonged use of BESIVANCE may result in overgrowth of non-susceptible organisms, including fungi. If super-infection occurs, discontinue use and institute alternative therapy.
  • Patients should not wear contact lenses if they have signs or symptoms of bacterial conjunctivitis or during the course of therapy with BESIVANCE.
  • The most common adverse event reported in approximately 2% of patients treated with BESIVANCE was conjunctival redness. Other adverse events reported in patients receiving BESIVANCE occurring in approximately 1-2% of patients included: blurred vision, eye pain, eye irritation, eye pruritus and headache.
  • Safety and effectiveness in infants below one year of age have not been established.

Click here for full Prescribing Information for BESIVANCE.

References: 1. Asbell PA, Sanfilippo CM. Antibiotic resistance trends among ocular pathogens in the US—cumulative results from the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) surveillance study. US Ophthalmic Review. 2017;10(1):35-38. 2. Asbell PA, Sanfilippo CM, Pillar CM, DeCory HH, Sahm DF, Morris TW. Antibiotic resistance among ocular pathogens in the United States: Five-year results from the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) surveillance study. JAMA Ophthalmol. 2015;133(12):1445-1454. 3. Data on file. Bausch & Lomb Incorporated.

Indication

BESIVANCE® (besifloxacin ophthalmic suspension) 0.6% is a quinolone antimicrobial indicated for the treatment of bacterial conjunctivitis caused by susceptible isolates of the following bacteria: Aerococcus viridans*, CDC coryneform group G, Corynebacterium pseudodiphtheriticum*, Corynebacterium striatum*, Haemophilus influenzae, Moraxella catarrhalis*, Moraxella lacunata*, Pseudomonas aeruginosa*, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis*, Staphylococcus lugdunensis*, Staphylococcus warneri*, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae, Streptococcus salivarius*

*Efficacy for this organism was studied in fewer than 10 infections.

Important Safety Information
  • BESIVANCE is not for injection into the eye.
  • As with other anti-infectives, prolonged use of BESIVANCE may result in overgrowth of non-susceptible organisms, including fungi. If super-infection occurs, discontinue use and institute alternative therapy.
  • Patients should not wear contact lenses if they have signs or symptoms of bacterial conjunctivitis or during the course of therapy with BESIVANCE.
  • The most common adverse event reported in approximately 2% of patients treated with BESIVANCE was conjunctival redness. Other adverse events reported in patients receiving BESIVANCE occurring in approximately 1-2% of patients included: blurred vision, eye pain, eye irritation, eye pruritus and headache.
  • Safety and effectiveness in infants below one year of age have not been established.

Click here for full Prescribing Information for BESIVANCE.