Reduction of conjunctival bacterial flora by povidone-iodine, ofloxacin and chlorhexidine in an outpatient setting.

PURPOSE: To compare the reduction of conjunctival bacterial flora by povidone-iodine 4%, ofloxacin 0.3%, and chlorhexidine 0.05% for endophthalmitis prophylaxis before corneal suture removal in an outpatient setting.

METHODS

In each group of 25 consecutive subjects who presented for outpatient ophthalmic evaluation, one eye was treated with either povidone-iodine 4% (PI), ofloxacin 0.3% (Oflox) or chlorhexidine 0.05% (Chex). The other eye served as a control. Three minutes after treatment, cultures were taken from the inferior conjunctival sac in both eyes. Following incubation at 35 degrees for 48 hours, the numbers of colonies were counted and compared. The difference in the numbers of colonies in each pair of treated and control eyes was assessed for each drug and compared.

RESULTS

The reduction in colony-forming units was highly significant for each of the three drugs tested (Wilcoxon signed-ranks test; p < 0.0001). There was no significant difference between percent reduction by the three drugs (Kruskal-Wallis test; p = 0.68). Sterile cultures following preparation by PI, Oflox and Chex were obtained in 52%, 68% and 52%, respectively.

CONCLUSIONS

The regimens tested were similarly effective in reducing conjunctival commensals. They may all be considered as options for a quick prophylaxis against infection following suture removal in an outpatient setting.