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4/29/2019, Monday

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Results Show Resistance Among Some Common Strains, But Notes Longitudinal Decreases in Resistance Over 10 Years

Only Ongoing Annual Nationwide Surveillance of Ocular Pathogens in the U.S.

BRIDGEWATER, N.J., Apr. 29, 2019 – Bausch + Lomb, a leading global eye health company, today announced the results from nearly ten years of the ARMOR (Antibiotic Resistance Monitoring in Ocular MicRoorganisms) surveillance study, presented at the 2019 Association for Research in Vision and Ophthalmology (ARVO) Meeting in Vancouver, British Columbia.1 Researchers also presented preliminary 2018 surveillance data on antibiotic resistance levels.2 Initiated in 2009, ARMOR is the only ongoing multicenter survey of antibiotic resistance patterns specific to ocular pathogens in the United States.

“The ARMOR study is critically important research for the eye health community – providing a platform to identify key trends and provide insights among common ocular pathogens,” said Yolande Barnard, vice president and general manager, U.S. Pharmaceuticals, Bausch + Lomb. “Bausch + Lomb is proud to continue its support of this unique ongoing study to inform eye care practitioners so that they can help manage the treatment of their patients with ocular bacterial conjunctivitis.”

The ARMOR study tracks in vitro antibiotic susceptibility profiles among ocular bacterial pathogens of significance. Clinically relevant isolates of Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae from ocular infections are collected and subjected to antibiotic susceptibility testing.

In the longitudinal trend analysis presentation, ARMOR researchers reported resistance trends in staphylococcal infections, which included 2108 Staphylococcus aureus and 1721 coagulase-negative staphylococci that were collected since January 2009. The results of the analysis confirmed the previously reported decrease in methicillin resistance (MR) among S. aureus (P<0.001; 40 percent in 2018), but not among CoNS (P=0.762), with approximately half of CoNS exhibiting MR each year. In addition, decreased resistance was observed among S. aureus to azithromycin (62 percent to 60 percent), ciprofloxacin (39 percent to 30 percent), tobramycin (24 percent to 9 percent), and chloramphenicol (6.6 percent to 4.4 percent; P≤0.006 for all). Among CoNS, resistance to ciprofloxacin decreased (46 percent to 31 percent; P<0.001), while there was increased resistance to tobramycin (19 percent to 23 percent; P=0.036). As in previous years, a high proportion of methicillin-resistant staphylococci demonstrated multidrug resistance (≥3 antibiotic classes).

In the 2018 preliminary update, ARMOR researchers reported a total of 414 isolates collected from 15 participating sites in the United States. Among staphylococci, resistance rates appeared similar to 2017 rates, with considerable resistance among staphylococci to azithromycin (52-60 percent), oxacillin/methicillin (30-49 percent), and ciprofloxacin (30-31 percent). CoNS isolates also exhibited resistance to trimethoprim (25 percent) and tobramycin (23 percent). Multidrug resistance (MDR) was observed in 30 percent of S. aureus and 40 percent of CoNS and was especially prevalent among methicillin-resistant staphylococci (72-77 percent). Isolates of S. pneumoniae were resistant to azithromycin (33 percent) and oral penicillin (28 percent) with no resistance to fluoroquinolones. All isolates of P. aeruginosa were susceptible to fluoroquinolones, with six percent exhibiting resistance to polymyxin B. With the exception of a single tetracycline-resistant isolate, all H. influenzae were susceptible to tested drugs.2

“As the only annual nationwide surveillance study of its kind, these data continue to serve as an invaluable resource to eye care professionals in tracking updated susceptibility rates to commonly used antibiotics among ocular pathogens,” said Penny A. Asbell, M.D., lead ARMOR study author, professor and chair, the University of Tennessee Health Science Center, and director, Hamilton Eye Institute, Memphis, TN. “As an eye care professional myself, I’m grateful for the opportunity to equip practitioners with resources to help them make knowledgeable decisions in meeting the needs of their patients.”

About Bausch + Lomb

Bausch + Lomb, a division of Bausch Health, is a leading global eye health organization that is solely focused on helping people see. Its core businesses include over-the-counter products, dietary supplements, eye care products, ophthalmic pharmaceuticals, contact lenses, lens care products, ophthalmic surgical devices and instruments. Bausch + Lomb develops, manufactures and markets one of the most comprehensive product portfolios in the industry, which is available in more than 100 countries. For more information, visit


  1. Asbell, Penny A,.; Sanfilippo, Christine M; DeCory, Heleen H. “Longitudinal Trends in Antibiotic Resistance Among Staphylococci Collected in the ARMOR Study.” [The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting in Vancouver, BC, on Sunday, April 28, 1:00-2:45, Abstract Number: B0331].
  2. Sanfilippo, Christine M.; DeCory, Heleen H.; Asbell, Penny A. “Antibiotic Resistance Among Ocular Pathogens – An Update from the 2018 ARMOR Study.” [The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting in Vancouver, BC, on Sunday, April 28, 8:00-9:45, Abstract Number: B0365].








Dr. Penny Asbell receives financial compensation as an advisory board member for Bausch + Lomb.
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