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Safety and Tolerability of Besifloxacin Ophthalmic Suspension 0.6% in the Treatment of Bacterial Conjunctivitis

Data from Six Clinical and Phase I Safety Studies

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Abstract

Background: Besifloxacin is a novel fluoroquinolone, specifically a chlorofluoroquinolone, with potent broad-spectrum bactericidal activity for the topical treatment of bacterial conjunctivitis.

Objective: The objective of this report was to provide a comprehensive assessment of the safety and tolerability of besifloxacin ophthalmic suspension 0.6% across clinical and phase I safety studies.

Methods: Data were drawn from two phase I safety studies in healthy adults, an open-label, phase II pharmacokinetic study of patients with bacterial conjunctivitis and from integrated data from three randomized, double-masked, parallel-group, safety and efficacy studies of patients with bacterial conjunctivitis (two were vehicle controlled and one was active controlled with moxifloxacin ophthalmic solution 0.5%, as base). Safety assessments included changes in visual acuity, ocular assessments with ophthalmoscopy and biomicroscopy, and assessment of adverse events (AEs).

Results: Safety data for besifloxacin ophthalmic suspension 0.6% were available for 1350 patients, including 1192 patients (1810 eyes) in the integrated analysis. Systemic exposure following topical administration of besifloxacin ophthalmic suspension 0.6% was negligible. No changes were seen in corneal endothelial cell density. In the integrated safety analysis of the three safety and efficacy studies, the most commonly reported ocular AEs in study eyes receiving besifloxacin ophthalmic suspension 0.6% were blurred vision (2.1 %), eye pain (1.8%), eye irritation (1.4%), nonspecific conjunctivitis (1.2%) and eye pruritus (1.1%). Blurred vision, eye irritation and nonspecific conjunctivitis occurred in significantly fewer besifloxacin-treated patients than in vehicle-treated patients (p≤0.05). Headache (1.8%) was the most frequently reported non-ocular AE. Most AEs were mild in severity and there were no treatment-related serious AEs. Besifloxacin ophthalmic suspension 0.6% did not significantly affect visual acuity, biomicroscopy or ophthalmoscopy compared with vehicle or moxifloxacin.

Conclusion: The results from this comprehensive data set of 1350 patients demonstrate that besifloxacin ophthalmic suspension 0.6% has a favourable safety profile and is well tolerated.

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References

  1. Diamant JI, Hwang DG. Therapy for bacterial conjunctivitis. Ophthalmol Clin N Am 1999; 12(1): 15–20

    Article  Google Scholar 

  2. Sheikh A, Hurwitz B. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev 2006; 19(2):CD001211

    Google Scholar 

  3. Høvding G. Acute bacterial conjunctivitis. Acta Ophthalmol Scand 2008; 86(1): 5–17

    Google Scholar 

  4. Cavuoto K, Zutshi D, Karp CL, et al. Update on bacterial conjunctivitis in South Florida. Ophthalmology 2008; 115(1): 51–6

    Article  PubMed  Google Scholar 

  5. Ward KH, Lepage J-F, Driot J-Y. Nonclinical pharmacodynamics, pharmacokinetics, and safety of BOL-303224-A, a novel fluoroquinolone antimicrobial agent for topical ophthalmic use. J Ocular Phamacol Ther 2007; 23(3): 243–56

    Article  CAS  Google Scholar 

  6. Cambau E, Matrat S, Pan X-S, et al. Target specificity of the new fluoroquinolone besifloxacin in Streptococcus pneumoniae, Staphylococcus aureus and Escherichia coli. J Antimicrob Chemother 2009; 63(3): 443–50

    Article  PubMed  CAS  Google Scholar 

  7. Haas W, Pillar CM, Zurenko GE, et al. Besifloxacin, a novel fluoroquinolone, has broad-spectrum in vitro activity against aerobic and anaerobic bacteria. Antimicrob Agents Chemother 2009; 53(8): 3552–60

    Article  PubMed  CAS  Google Scholar 

  8. Haas W, Zurenko GE, Lee J, et al. Activity of besifloxacin and comparators against ciprofloxacin resistant Staphylococcus aureus and Staphylococcus epidermidis ocular isolates from 2005–2008. Poster presented at the 3rd Congress of the Federation of European Microbiologists; 2009 Jun 28–Jul 2; Gothenberg

  9. Haas W, Pillar CM, Hesje CK, et al. Bactericidal activity of besifloxacin against staphylococci, Streptococcus pneumoniae and Haemophilus influenzae. J Antimicrob Chemother 2010; 65(7): 1441–7

    Article  PubMed  CAS  Google Scholar 

  10. Besivance [package insert]. Tampa (FL): Bausch & Lomb, Inc., 2009

  11. Friedlander MH, Protzko E. Clinical development of 1% azithromycin in DuraSite, a topical azalide anti-infective for ocular surface therapy. Clin Ophthalmol 2007; 1(1): 3–10

    Google Scholar 

  12. Mehlhorn AJ, Brown DA. Safety concerns with fluoro-quinolones. Ann Pharmacother 2007; 41(11): 1859–66

    Article  PubMed  Google Scholar 

  13. Gross RD, Hoffman RO, Lindsay RN. A comparison of ciprofloxacin and tobramycin in bacterial conjunctivitis in children. Clin Pediatr (Phila) 1997; 36(8): 435–44

    Article  CAS  Google Scholar 

  14. Gwon A, for the Ofloxacin Study Group II. Ofloxacin vs tobramycin for the treatment of external ocular infection. Arch Ophthalmol 1992; 110(9): 1234–7

    Article  PubMed  CAS  Google Scholar 

  15. Gwon A, for the Ofloxacin Study Group. Topical ofloxacin compared with gentamicin in the treatment of external ocular infection. Br J Ophthalmol 1992; 76(12): 714–8

    Article  PubMed  CAS  Google Scholar 

  16. Hwang DG, Schanzlin DJ, Rotberg MH, et al., and the Levofloxacin Bacterial Conjunctivitis Placebo-controlled Study Group. A phase III, placebo controlled clinical trial of 0.5% levofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis. Br J Ophthalmol 2003; 87(8): 1004–9

    Article  PubMed  CAS  Google Scholar 

  17. Lichtenstein SJ, Rinehart M, and the Levofloxacin Bacterial Conjunctivitis Study Group. Efficacy and safety of 0.5% levofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis in pediatric patients. J AAPOS 2003; 7(5): 317–24

    Article  PubMed  Google Scholar 

  18. Roberts C. Comparison of the ocular comfort of ofloxacin 0.3% ophthalmic solution and lubricant eye drops. Clin Pediatr (Phila) 2002; 41(3): 151–4

    Article  Google Scholar 

  19. Schwab IR, Friedlaender M, McCulley J, et al., for the Levofloxacin Bacterial Conjunctivitis Active Control Study Group. A phase III clinical trial of 0.5% levofloxacin ophthalmic solution versus 0.3% ofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis. Ophthalmology 2003; 110(3): 457–65

    Article  PubMed  Google Scholar 

  20. Silver LH, Woodside AM, Montgomery DB. Clinical safety of moxifloxacin ophthalmic solution 0.5% (Vigamox®) in pediatric and nonpediatric patients with bacterial conjunctivitis. Surv Ophthalmol 2005; 50(1 Suppl.): S55–63

    Article  PubMed  Google Scholar 

  21. Yee RW, Tepedino M, Bernstein P, et al., for the Gatifloxacin BID/QID Study Group. A randomized, investigator-masked clinical trial comparing the efficacy and safety of gatifloxacin 0.3% administered BID versus QID for the treatment of acute bacterial conjunctivitis. Curr Med Res Opin 2005; 21(3): 425–31

    Article  PubMed  CAS  Google Scholar 

  22. Thompson AM. Ocular toxicity of fluoroquinolones. Clin Experiment Ophthalmol 2007; 35(6): 566–77

    Article  PubMed  Google Scholar 

  23. Karpecki P, DePaolis M, Hunter JA, et al. Besifloxacin ophthalmic suspension 0.6% in patients with bacterial conjunctivitis: a multicenter, prospective, randomized, double-masked, vehicle-controlled, 5-day efficacy and safety study. Clin Ther 2009; 31(3): 514–26

    Article  PubMed  CAS  Google Scholar 

  24. Tepedino ME, Heller WH, Usner DW, et al. Phase III efficacy and safety study of besifloxacin ophthalmic suspension 0.6% in the treatment of bacterial conjunctivitis. Curr Med Res Opin 2009; 25(5): 1159–69

    Article  PubMed  CAS  Google Scholar 

  25. McDonald MB, Protzko EE, Brunner LS, et al. Efficacy and safety of besifloxacin ophthalmic suspension 0.6% compared with moxifloxacin ophthalmic solution 0.5% for treating bacterial conjunctivitis. Ophthalmology 2009; 116(9): 1615–23

    Article  PubMed  Google Scholar 

  26. Proksch JW, Granvil CP, Siou-Mermet R, et al. Ocular pharmacokinetics of besifloxacin following topical administration to rabbits, monkeys, and humans. J Ocul Pharmacol Ther 2009; 25(4): 335–44

    Article  PubMed  CAS  Google Scholar 

  27. Zymar [package insert]. Irvine (CA): Allergan, Inc., 2004

  28. Vigamox [package insert]. Fort Worth (TX): Alcon Laboratories, Inc., 2008

  29. Baudouin C. Detrimental effect of preservatives in eye drops: implications for the treatment of glaucoma. Acta Ophthalmologica 2008; 86(7): 716–26

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Funding for the study analysis described herein was provided by Bausch & Lomb, Inc. All studies were sponsored by Bausch & Lomb, Inc. The authors are employees of Bausch & Lomb, Inc. and take responsibility for the integrity and accuracy of the data. The authors thank Rosemary Reinke, PhD, of Churchill Communications for writing assistance.

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Correspondence to Timothy L. Comstock.

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Comstock, T.L., Paterno, M.R., DeCory, H.H. et al. Safety and Tolerability of Besifloxacin Ophthalmic Suspension 0.6% in the Treatment of Bacterial Conjunctivitis. Clin. Drug Investig. 30, 675–685 (2010). https://doi.org/10.2165/11536720-000000000-00000

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  • DOI: https://doi.org/10.2165/11536720-000000000-00000

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