Evaluation of antimicrobial effectiveness of ophthalmic drops according to the pharmacopeial tests criteria

Background: In this study antimicrobial effectiveness test was performed on eye-drops which had high microbial contaminations in hospital practice to find out whether their antimicrobial efficacies affect the magnitude of microbial contamination during their uses. Materials and Methods: Artificial tear, atropine sulfate, betamethasone, homatropine hydrobromide, phenylephrine hydrochloride, phenylephrine zinc, pilocarpine hydrochloride, tetracaine hydrochloride and tropicamide eye-drops were subjected to the United States Pharmacopeia (USP) and British Pharmacopeia (BP) antimicrobial preservative effectiveness tests. Results: The results of this study showed that eight out of the nine products n1et the BP B and USP criteria. The preservative employed in phenylephrine zinc eye-drop did not possess adequate antimicrobial activity against P. aeruginosa. Other eye-drops showed appropriate reductions in bacterial viability after 6 hrs, 24 hrs and 7 days, but showed a very low bacterial recovery after 28 days which didn t comply with the no recovery (NR) term of BP A criteria. Since viable microbial counts were usually determined by plate count method, it seems that the term ofNR should define an acceptable range. Conclusion: The results indicated that there is not a clear correlation between antimicrobial efficacy testing of eye-drops and the rate of their microbial contamination while are being used. Other factors such as hygienic practices of eye-drops, proper bottle design and training of patients could influence their microbial contaminations. Regulation of in-use efficacy testing of eye-drops which is influenced by the environment, the frequency and technique of use, might be essential.