Effect of topical povidone-iodine versus topical ofloxacin on experimental Staphylococcus keratitis

PURPOSE

To compare the antibacterial effect of povidone-iodine (PI) with that of ofloxacin in an experimental model of bacterial keratitis.

METHODS

Staphyloccocal keratitis was induced in 21 eyes of Dutch Belted rabbits by intrastromal inoculation of approximately 280 organisms of Staphylococcus aureus. Six hours later, the animals were divided in four groups treated topically with saline 0.9%, Betadine 10%, Betadine 0.5% or Ofloxacin 0.3% (2 gtt every 30 min for 8 h). The central 8-mm cornea was excised, washed and homogenized. Colony counts were performed on serial 10-fold dilutions plated on blood and brain infusion agar and incubated overnight.

RESULTS

Colony-forming units per cornea were 7.4x10(7) for the saline group compared to 8.2x10(7) for PI 10% (P>0.5), 4.3x10(7) for PI 0.5% (P<0.01) and no organisms for ofloxacin 0.3%.

CONCLUSIONS

Betadine 0.5% demonstrates a statistically significant bactericidal effect compared with untreated staphyloccocal keratitis in our experimental model. Ofloxacin has superior antibacterial effect under the conditions studied. Further improvements in the povidone-iodine formulation are warranted prior to consideration for human keratitis.

Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome

BACKGROUND

Chronic fatigue syndrome (CFS) is a disorder of unknown etiology, consisting of prolonged, debilitating fatigue, and a multitude of symptoms including neurocognitive dysfunction, flu-like symptoms, myalgia, weakness, arthralgia, low-grade fever, sore throat, headache, sleep disturbances, and swelling and tenderness of lymph nodes. No effective treatment for CFS is known.

OBJECTIVE

The purpose of the study was to evaluate the efficacy of the reduced form of nicotinamide adenine dinucleotide (NADH) i.e., ENADA the stabilized oral absorbable form, in a randomized, double-blind, placebo-controlled crossover study in patients with CFS. Nicotinamide adenine dinucleotide is known to trigger energy production through ATP generation which may form the basis of its potential effects.

METHODS

Twenty-six eligible patients who fulfilled the Center for Disease Control and Prevention criteria for CFS completed the study. Medical history, physical examination, laboratory studies, and questionnaire were obtained at baseline, 4, 8, and 12 weeks. Subjects were randomly assigned to receive either 10 mg of NADH or placebo for a 4-week period. Following a 4-week washout period, subjects were crossed to the alternate regimen for a final 4-week period.

RESULTS

No severe adverse effects were observed related to the study drug. Within this cohort of 26 patients, 8 of 26 (31%) responded favorably to NADH in contrast to 2 of 26 (8%) to placebo. Based upon these encouraging results we have decided to conduct an open-label study in a larger cohort of patients.

CONCLUSION

Collectively, the results of this pilot study indicate that NADH may be a valuable adjunctive therapy in the management of the chronic fatigue syndrome and suggest that further clinical trials be performed to establish its efficacy in this clinically perplexing disorder.