Intraocular Safety of Ciprofloxacin

Stevens, Scott; Fouraker, Bradley D.; Jensen, Harold G.

doi:10.1001/archopht.1991.01080120121040

Cited by 36 publications

(20 citation statements)

References 63 publications

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“…As observed by others, results of electroretinography indicated an immediate decrease in baseline retinal function in the study as well as in the control eyes on the day after the injection with subtotal recovery until 14 days after the injection [24]. These unspecific ERG changes can only be explained by the ocular trauma during intravitreal injection.…”

Section: Discussionsupporting

confidence: 81%

“…However, they have not been applied for direct intravitreal injection for the treatment of endophthalmitis, because of lack of sufficient experimental data. Only a few studies have been done to evaluate the intraocular compatibility of quinolones [18][19][20][21][22][23][24]. Ciprofloxacin (CFLX), a second-generation fluoroquinolone, has a broad antibacterial spectrum and a good antimicrobial activity against the most common gram-positive and gram-negative ocular pathogenic bacteria [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

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Experimental Intravitreal Application of Ciprofloxacin in Rabbits

Wiechens¹,

Grammer

Johannsen³

et al. 1999

Ophthalmologica

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Background: Ciprofloxacin (CFLX) is a fluoroquinolone antibiotic with a broad antimicrobial spectrum. This study was performed to examine the retinal toxicity of free and liposome-incorporated CFLX in rabbit eyes after intravitreal injection. Materials and Methods: Free CFLX in doses of 100, 250, 500, 1,000 and 2,000 µg was injected into the midvitreous of rabbit eyes (n = 28). To prolong the intravitreal antibacterial level, CFLX was incorporated into multilamellar liposomes: 0.1 ml of this suspension (≙ 273.6 µg CFLX) was injected into the midvitreous of a second group of rabbit eyes (n = 6). The other eye served as a control and received normal saline solution or empty liposomes, respectively. Before injection and at the end of follow-up an electroretinogram (ERG) was obtained. After a follow-up of 1, 14 and 28 days the animals were perfused with glutaraldehyde and the eyes were examined by light and transmission electron microscopy. Results: Significant reduction of the ERG was observed after 2,000 µg free CFLX in 4 out of 6 eyes after 14 days. Fourteen days after injection of 2,000 µg CFLX the central retina showed pigmentary changes in 4 out of 6 eyes. In the second group the ERG as well as the histologic studies did not reveal any pathologic changes after injection of liposome-incorporated CFLX compared to the control eyes. Conclusion: In therapeutic doses of 100–500 µg, free CFLX does not have retinal toxicity in rabbit eyes. No retinal toxicity was observed after intravitreal injection of liposome-incorporated CFLX.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Experimental Intravitreal Application of Ciprofloxacin in Rabbits

Wiechens¹,

Grammer

Johannsen³

et al. 1999

Ophthalmologica

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“…Despite broad-spectrum antibacterial activity, fluoroquinolones are not widely used for direct intraocular administration, due in part to concerns regarding possible toxicity (129,152). The emergence of antibiotic-resistant organisms, particularly vancomycin-resistant gram-positive pathogens, such as Enterococcus faecalis and potentially S. aureus, may affect future therapeutic design.…”

Section: Choice Of Antimicrobial Agentmentioning

confidence: 99%

Bacterial Endophthalmitis: Epidemiology, Therapeutics, and Bacterium-Host Interactions

et al. 2002

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SUMMARY Endophthalmitis is a severe inflammation of the interior of the eye caused by the introduction of contaminating microorganisms following trauma, surgery, or hematogenous spread from a distant infection site. Despite appropriate therapeutic intervention, bacterial endophthalmitis frequently results in visual loss, if not loss of the eye itself. Although the pathogenicity of bacterial endophthalmitis has historically been linked with toxin production during infection, a paucity of information exists as to the exact mechanisms of retinal toxicity and the triggers for induction of the intraocular immune response. Recently, research has begun to examine the bacterial and host molecular and cellular events that contribute to ocular damage during endophthalmitis. This review focuses on the causative agents and therapeutic challenges of bacterial endophthalmitis and provides current data from the analysis of the role of bacterial virulence factors and host inflammatory interactions in the pathogenesis of eye infections. Based on these and related studies, a hypothetical model for the molecular pathogenesis of bacterial endopthalmitis is proposed. Identifying and understanding the basic mechanisms of these bacterium-host interactions will provide the foundation for which novel, information-based therapeutic agents are developed in order to prevent vision loss during endophthalmitis.

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“…41,42 The emergence of antibiotic-resistant organisms, particularly vancomycin-resistant Gram-positive pathogens, e.g. Enterococcus faecalis and potentially S. aureus, may affect future therapeutic design.…”

Section: 33mentioning

confidence: 99%

Treatment of Postoperative Endophthalmitis

Spadea¹

2014

US Ophthalmic Review

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Endophthalmitis is a feared complication of trauma, surgical procedures, and septicemia. The rates of postoperative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Postoperative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of postoperative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withStaphyloccus aureus, enterococci,Bacillus, or Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating postoperative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub conjunctival, systemic, or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous in terms of the intravitreal antibiotic injection.

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Intraocular Safety of Ciprofloxacin

Cited by 36 publications

References 63 publications

Experimental Intravitreal Application of Ciprofloxacin in Rabbits

Experimental Intravitreal Application of Ciprofloxacin in Rabbits

Bacterial Endophthalmitis: Epidemiology, Therapeutics, and Bacterium-Host Interactions

Treatment of Postoperative Endophthalmitis

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