Published: 2018-04-23

Evaluation of used eye drop containers for microbial contamination in outpatient department of tertiary care teaching hospital

Narendra P. Bachewar, Durgesh Deshmukh, Sachin R. Choudhari, R. S. Joshi


Background: Contaminated eyedrops are considered as serious risk factor for many iatrogenic ocular infections. Apart from the risk of infection, microbial contamination may alter the pH of the solution thereby reducing the efficacy of drugs. Presently many preservatives are added to these eye drops preparations to extend the duration of use. Hence authors aimed this study to find the contamination rates in such eye drop preparations.

Methods: This was a prospective observational research conducted at Ophthalmology OPD, of tertiary care teaching hospital for the period of 2 months. Total fifty five used eyedrops were collected.

Results: Authors found that 25.45% of the collected eye drops were contaminated with various organisms, viz. E. coli (10.90%), Staphylococcus aureus (9.09%), Pseudomonas aerugenosa (1.81%), Bacillus subtilis (1.81%) and Candida albicans (1.81%). Among various eyedrops, mydriatic (60%) eyedrops had the highest rate of contamination. We also found that, different preservatives in the eye drops were presents with different level of microbial contamination.

Conclusions: The present study showed that there is a definite co-occurrence between eyedrop contamination and ocular infections irrespective of preservatives. This research raises a concern about questionable efficacy of preservatives.



Eyedrops, Preservatives, Ocular infections

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Nentwich MM, Kollmann KHM, Meshack J, Ilako DR, Schaller UC. Microbial contamination of ophthalmic solutions in Kenya.Br J Ophthalmol 2007;91:1265-8.

Du Bois SK, Pinne y RJ, Davison AL. Investigation of the levels of bacterial contamination in used eye drops. Pharm J. 1989;237:R39.

Jolly S. British pharmaceutical codex. London: The Pharmaceutical Press; 1966.

British national formulary. London: The Pharmaceutical Press; 2001.

Livingstone DJ, Hanlon GW, Dyke S. Evaluation of an extended period of use for preserved eye drops in hospital practice. Br J Ophthalmol. 1998;82:473-5.

Perry HD, Donnenfeld ED. Issues in the use of preservative free topical manag care. 2003;12:39-41.

Raynaud C, Laveran H, Rigal D, Bonicel P. Bacterial contamination of eyedrops in clinical use. Journal francais d'ophtalmologie. 1997;20(1):17-24.

Soc. Belge Z. Antimicrobial agents in eye drops. Ceska slov farm. 2004;53:107-16.

Clark PJ, Ong B, Stanely CB. Contamination of diagnostic ophthalmic solutions in primary eye care settings. Mil Med. 1997;162:501-6.

Geyer O, Bottone EJ, Podos SM, Schumer RA, Asbell PA. Microbial contamination of medications used to treat glaucoma. British journal of ophthalmology. 1995 Apr 1;79(4):376-9.

Larsen HS. Laboratory identification of significant isolates. In: Connie RM, ed. Textbook of diagnostic microbiology. Philadelphia: W.B. Saunders Company; 2000:330-399.

Brudieu E, Duc DL, Masella JJ, Croize J, Valence B, Meylan I, et al. Bacterial contamination of multi-dose ocular solutions. A prospective study at the Grenoble Teaching Hospital. Pathologie-biologie. 1999 Dec;47(10):1065-70.

Wessels IF, Bekendam P, Calvin WS, Zimmerman GJ. Open drops in ophthalmology offices: expiration and contamination. Ophthalmic Surgery, Lasers and Imaging Retina. 1999 Jul 1;30(7):540-6.

Razooki RA, Saeed EN, Al-Deem HI. Microbial Contamination of Eye Drops in out Patient in Iraq. Iraqi Journal of Pharmaceutical Sciences (ISSN: 1683-3597, ESSN: 2521-3512). 2017 Mar 29;20(2):91-5.

Fazeli MR, Nejad HB, Mehrgan H, Elahian L. Microbial contamination of preserved ophthalmic drops in outpatient departments: possibility of an extended period of use. DARU Journal of Pharmaceutical Sciences. 2004;12(4):151-5.

Rahman MQ, Tejwani D, Wilson JA, Butcher I, Ramaesh K. Microbial contamination of preservative free eye drops in multiple application containers. British journal of ophthalmology. 2006 Feb 1;90(2):139-41.

Saisyo A, Oie S, Kimura K, Sonoda KH, Furukawa H. Microbial contamination of in-use ophthalmic preparations and its prevention. Bull. Yamaguchi Med. Sch. 2016;63:17-24.

Feghhi M, Zarei Mahmoudabadi A, Mehdinejad M. Evaluation of fungal and bacterial contaminations of patient-used ocular drops. Medical mycology. 2008 Feb 1;46(1):17-21.

Dalal P. Eye drops and its expiration [Internet]. 2017 July. [Accessed on 2018 Jan 25] Available at: