Non-preserved 1% lidocaine solution has less antibacterial properties than currently available anaesthetic eye-drops

Abstract

Purpose. Some anaesthetics inhibit bacterial growth, and thus may lead to low rates of positive cultures from bacterial eratitis. Antibacterial properties of lidocaine were compared with those of oxybuprocaine or tetracaine, either in current commercial eye lotions or in extemporaneous solutions. Methods. Forty-eight bacterial strains were used to determine the minimum inhibitory and bactericidal concentrations of four commercial eye lotions containing oxybuprocaine or tetracaine, of a non-ophthalmic 1% lidocaine commercial solution and of extemporaneously prepared solutions of oxybuprocaine, tetracaine, lidocaine and benzalkonium. Results. Most strains had their growth inhibited by 0.2% oxybuprocaine or 0.4% tetracaine, which corresponds to a 1/2 dilution of the commercial eye-drops. Bacterial growth was still observed with a 1% lidocaine solution. Conclusions. Currently available anaesthetic eye-drops that are used before corneal specimen collection may lead to false-negative bacterial cultures. Conversely, a non-preserved 1% lidocaine solution might be more appropriate in corneal specimen collection.