**5. Conclusions**

Netilmicin exhibits superior activity against the most common ocular bacterial strains, with faster and greater inhibitory potency in target tissues than other ophthalmic antibiotics. QI data on cornea and conjunctiva in rabbits demonstrated that netilmicin 0.3% is better than the other products when tested in both dosage forms, that is, eye drops solution and gel. Importantly, netilmicin 0.3% gel, due to the presence of 1% xanthan gum prolongs the retention time on the ocular surface and, consequently, increases the Cmax. Therefore, based on the severity of the pathology and any other concerns (e.g. corneal healing) associated with bacterial conjunctivitis, it is possible to use netilmicin 0.3% eye drops solution or gel formulation. Moreover, netilmicin offers an excellent broad-spectrum coverage against all tested isolates, including MRSA and MRSE, compared with other ophthalmic antibiotics. These findings are of particular interest considering that among ocular isolates, the frequency of MRSE and MRSA in bacterial conjunctivitis is increasing. Overall,

these data support the use of netilmicin as a first-line agent in the treatment of such bacterial ocular infections, due to ocular safety, potency and low resistance.
