Antibiotic resistance in ocular bacterial infections: an integrative review of ophthalmic chloramphenicol

• Published in: Tropical Medicine and Health
• Main Authors: Babatunde Ismail Bale, Emmanuel Ebuka Elebesunu, Pirakalai Manikavasagar, Favour Obianuju Agwuna, Isaac Olushola Ogunkola, Alhaji Umar Sow, Don Eliseo Lucero-Prisno
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Chloramphenicol; Drug; Antibiotic resistance; Ophthalmic; Infection; Treatment; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s41182-023-00496-x; https://doaj.org/article/9574ea5b971c49b3ba330094288439b1

Abstract Introduction Chloramphenicol is a broad-spectrum antibiotic widely used for treating ophthalmic infections, but concerns about rising bacterial resistance to chloramphenicol have been observed due to its frequent use as an over-the-counter medication. This review assessed the common ophthalmic bacterial pathogens, their chloramphenicol resistance mechanisms, and rates of drug resistance. Methods PubMed and Google Scholar databases were searched for relevant publications from the years 2000 to 2022, bordering on ophthalmic bacterial infections, chloramphenicol susceptibility profiles, and drug resistance mechanisms against chloramphenicol. A total of 53 journal publications met the inclusion criteria, with data on the antibiotic susceptibility profiles available in 44 of the reviewed studies, which were extracted and analyzed. Results The mean resistance rates to chloramphenicol from antibiotic susceptibility profiles varied between 0% and 74.1%, with the majority of the studies (86.4%) showing chloramphenicol resistance rates below 50%, and more than half (23 out of 44) of the studies showed resistance rates lower than 20%. The majority of the publications (n = 27; 61.4%) were from developed nations, compared to developing nations (n = 14; 31.8%), while a fraction (n = 3; 6.8%) of the studies were regional cohort studies in Europe, with no country-specific drug resistance rates. No pattern of cumulative increase or decrease in ophthalmic bacterial resistance to chloramphenicol was observed. Conclusions Chloramphenicol is still active against ophthalmic bacterial infections and is suitable as a topical antibiotic for ophthalmic infections. However, concerns remain about the drug becoming unsuitable in the long run due to some proof of high drug resistance rates.