Steroid-containing ophthalmic solutions more likely to be contaminated

Ophthalmic solutions containing steroids are 5.8 times more likely to be contaminated with bacteria than solutions that are steroid-free, according to a report published in the October issue of the British Journal of Ophthalmology.

Danny H-Kauffmann Jokl and colleagues from the New York Medical College, New York, USA conducted a study to assess the frequency of ophthalmic solution contamination in a long-term care facility. A total of 123 solutions used for patient treatment were cultured for bacteria and the results were analysed according to the therapeutic class of the solution, how long the bottle was in use for and the appearance of the bottle upon visual inspection.

Ten (8%) of the solutions were contaminated with bacteria: four of eight steroid-containing anti-inflammatory solutions, two of six combination antimicrobial and steroid-containing anti-inflammatory solutions, two of 34 solutions for the treatment of glaucoma and two of 57 medications for dry eye. None of the mydriatic, miotic or non-combination antimicrobial solutions were found to be contaminated.

Just 30% of the contaminated bottles were considered "dirty" under visual inspection. Neither length of time that bottles had been in use or appearance of the bottles were found to be predictors of contamination.

The frequent contamination during reuse of certain steroid-containing ophthalmic solutions has led the research team to suggest that single-use solutions may be preferable.