Besivance is a medication used in ophthalmology to treat certain types of bacterial infections of the eyes. This preparation was developed by the Japanese pharmaceutical company, which later sold its rights for the drug to the company “InSite Vision Incorporated”. The latter improved the initial form of the medication by turning it into eye drops form. In 2003, the rights for the drug distribution were sold to the American company Bauch+Lomb, which is known to be one of the worlds’ leaders in the distribution of medicines and remedies applied in the treatment of eyes.
Six years later, in 2009, the medication got the approval of the American FDA to be applied in the treatment of conjunctivitis associated with a bacterial infection.
How Besivance Work?
The active component of the Besivance eye drops is called besifloxacin. This preparation belongs to the group of the fourth generation fluoroquinolone antibiotics. It is highly efficacious against gram-positive, gram-negative, and anaerobic bacteria. Therefore, Besivance has a wide spectrum of action and can be applied in eye diseases provoked by different types of staphylococcal bacteria, streptococcal pathogens, and a number of other besifloxacin-sensitive bacteria.
The mechanism of action of the drug is based on the inhibition of the bacterial DNA gyrase and topoisomerase IV – the enzymes responsible for the synthesis and replication of the bacterial DNA. Affecting them, Besivance prevents the growth of the bacteria and leads to their death.
Why Besivance Is Better than other Generations of Quinolons?
The major benefit of Besivance is that it is the only preparation of its group specially designed for ocular use. This allows reducing the systemic exposure to the antibiotic, and thus, prevent the development of resistance, which is one of the crucial issues in the therapy of bacterial infections.
What Are Besivance Eye Drops Used For?
Besivance is effective against a wide spectrum of bacterial infections provoking inflammation of the eye. This drug is not effective in the therapy of infections having viral or fungal etiology. Therefore, it’s crucial to undergo a medical examination to determine the exact pathogen causing the inflammatory processes in the eye.
In the medical practice, Besivance is applied in the treatment and prevention of the following ophthalmological diseases and conditions:
- bacterial conjunctivitis;
- bacterial inflammation of the cornea of the eye;
- bacterial keratitis;
- prophylaxis of the ocular infection in patients undergoing laser therapy for cataract;
- prophylaxis of eye infection followed by ocular surgery.
Although bacterial infections may also provoke a number of other ocular diseases, one cannot use Besivance for stye or blepharitis as the efficiency of this medication against the mentioned infectious diseases hasn’t been proven in clinical studies. What’s more, in post-marketing reports, blepharitis is called one of the possible Besivance side effects.
Such conditions demand a complex therapy with antimicrobial agents and steroids that can reduce the inflammation and deal with the pathogen simultaneously. The medication combining both properties is called Tobradex. Unlike Besivance, Tobradex does treat blepharitis.
What Is Pink Eye? Can Besivance be Used for Pink Eye?
Pink eye is another name for conjunctivitis. In the United States, this disease affects about 6 million people a year. The pink eye is an inflammation of the conjunctiva – a transparent membrane that covers the whites of the eyes and the inner surface of the eyelid. Because of this the visibility of the small blood vessels in conjunctiva increases, making the eyes look pink.
Besivance is the exact medication that can help reduce the inflammation and eradicate the bacterial pathogen.
Dosage and General Recommendations on Administering the Medication
The preparation comes in a form of ophthalmic suspension, which contains 0.6% of besifloxacin, such a small concentration of the active ingredient allows using the drug topically. One of the common questions concerning the drug composition is “does Besivance contain aspirin?”. This is a total misbelief as acetylsalicylic acid is present neither among the active components of the medication nor in the list of its excipients.
The dosing regimen, as well as the duration of the therapy, depends on the pathogen that has provoked the eye infection, the aim of the drug administration (treatment or prophylaxis), the severity of the patient’s condition, and his/her response to the effects induced by the medication.
To treat bacterial conjunctivitis with Besivance, instill one drop of the medication to the affected eye every 6 to 12 hours a day. There’s no need to use the preparation for both eyes if only one of them is infected. Usually, the therapy lasts for 5 – 8 days. The symptoms of the infection may disappear sooner than in five days. This happens in approximately 70% of the treatment cases. However, this doesn’t mean you can withdraw from the therapy as the death of the pathogen takes more time. By day 5 of the treatment, the bacterial eradication reaches 90%. If you stop taking the medicine earlier, it will increase the chances of a relapse.
When used in pediatric patients, the dose of the drug shouldn’t be changed.
Due to the low risks of the bacteria developing resistance to Besivance, this drug can be effectively applied in patients, whose ocular infections don’t respond to the treatment with other antibiotics, like ciprofloxacin.
How to Use the Drops
The main recommendation one should keep to is taking care of the dropper tip sterility. You should be very careful every time you open the bottle to avoid the contact of the dropper tip with any surface, including your hands and eyes.
Besides, you should try to keep all the medication you drip into the eye in for at least a minute or two for it to absorb. Keeping your eyes closed for a minute or two with your head tilted back should be enough.
Missing a Dose. Is It a Problem?
It’s crucial not to miss intakes to get the maximum positive effect from the treatment. Work out a schedule of instillations and keep to it daily to help yourself remember about the use of the medication. In case you miss a dose of Besivance, instill it right after you remember about that. If your next intake is close, skip the dose.
Who Should Avoid Taking Besivance?
Due to the topical application of Besivance, this drug has few contraindications. One of them is the application in the eye infections provoked by viruses or fungi. The active ingredient of the medication is not active against such pathogens. Therefore, its effect will be null.
Besivance should never be prescribed to the patients with a known hypersensitivity to besifloxacin or other medicines belonging to the quinolone group of antibiotics. The preparation also contains some inactive components, which may also be the reason for severe allergic reactions.
The safety of Besivance use in babies younger than 1 year of age hasn’t been studied. Therefore, it’s contraindicated in this category of patients.
Precautions to the Therapy with Besivance
Besivance is a drug that can only be bought by prescription. Therefore, a doctor’s consultation is an obligatory condition for the initiation of treatment. To make sure this drug is safe for you and won’t cause any serious adverse effects, it is recommended to inform your healthcare provider about all the prescription and over-the-counter meds you currently use.
Please, keep in mind that Besivance can induce some adverse reactions that may worsen the quality of your sight (e.g. blurred vision). It is strongly advised to avoid driving a car or operating machinery until your vision gets back to the norm.
If speaking about pregnant women, Besivance can be used in such patients when the potential benefits for the mother prevail on the possible risks for the fetus.
Such a requirement is associated with the results of the animal studies where Besivance caused maternal toxicity.
It is not known whether this preparation gets into breast milk. So if there’s a need to use Besivance in lactating women. It is better to stop breastfeeding the nursing baby at least by the end of the treatment.
Avoid wearing contact lenses during the treatment with Besivance at least by the time clinical manifestations of the infection are gone. You can put the contact lenses in at least 15 minutes after instilling the preparation.
What Are the Possible Adverse Reactions to Besivance?
The topical application of the antibiotic has a positive effect on its side effects profile. The incidence rate of the most common drug side effects ranges from 1% to 10%. All the unwanted effects, if any, are associated with the eye (eyes, in case both are infected) to which the medication is applied. They are the following:
- eye redness;
- itching;
- sore eyes;
- blurred vision;
- swelling of the eyelids;
- pain in the eyes;
- a headache.
Usually, such reactions don’t need medical treatment, yet you’d better inform your attending doctor if any of these occur, persist, or get worse.
Besivance eye drops never provoke adverse reactions associated with the cardiovascular system, liver, or kidneys.
Can Besivance upset your stomach?
No, Besivance is not intended for oral use. Therefore, it has no impact on the gastric tract and can’t be the cause of any gastrointestinal symptoms in patients using it topically.