[20] However, the treatment period was longer and the response rate was lower in patients with dacryocystitis than in patients with other infections. As discussed above, treatment of dacryocystitis with an ophthalmic solution alone seems to be insufficient. This is because the duration of dacryocystitis is often longer than those of other ocular infections; dacryocystitis is often relapsing in nature; and #Selleckchem 4SC-202 randurls[1|1|,|CHEM1|]# surgical treatments, such as dacryocystorhinostomy, are often necessary for the treatment of this disease, as it can obstruct the nasolacrimal duct.[21] As for the dosing frequency of levofloxacin 0.5% ophthalmic solution, it was higher in patients with bacterial corneal ulcers than in patients

with other ocular diseases. This is because if corneal ulcers are aggravated, visual disorders may occur. Because of this, the Japanese guidelines on management of infectious keratitis, which were made public in October 2007, recommend NVP-LDE225 frequent application

of antimicrobial ophthalmic solution in patients with severe infectious keratitis.[22] This study also indicates that when treating bacterial corneal ulcers, treatment can be completed within 8 days in half of all cases if levofloxacin 0.5% ophthalmic solution is applied 4–6 times daily. Increasing the frequency of dosing of levofloxacin 0.5% ophthalmic solution did not elevate the incidence of ADRs. Conclusion This post-marketing surveillance of levofloxacin 0.5% ophthalmic solution (Cravit® ophthalmic solution), conducted over 4 years, confirms the safety and efficacy Acyl CoA dehydrogenase of levofloxacin 0.5% ophthalmic solution in regular clinical use and highlights that it is a promising treatment for a variety of external ocular bacterial infections. Acknowledgments This study was originally published in Japanese in Rinsho Ganka, the Japanese Journal of Clinical Ophthalmology.[23] The study has been reproduced here in English with kind permission of the publisher of Rinsho Ganka, Igaku-Shoin Ltd. The authors would like to thank Simone Boniface of inScience Communications, Springer Healthcare, who provided medical writing assistance (funded by Santen

Pharmaceutical Co., Ltd.); Akio Nomura of Santen Pharmaceutical Co., Ltd., for reviewing and editing the paper; and the healthcare professionals who participated in this study and gave their cooperation with the survey and supply of valuable data. At the time when this research was conducted, all authors were employees of Santen Pharmaceutical Co., Ltd., which manufactures the product described in this research. References 1. Cravit® ophthalmic solution: prescribing information. Osaka: Santen Pharmaceutical Co., Ltd., 2005 Oct 2. Rose P. Management strategies for acute infective conjunctivitis in primary care: a systematic review. Expert Opin Pharmacother 2007 Aug; 8(12): 1903–21PubMedCrossRef 3. Une T, Fujimoto T, Sato K, et al.