Penetration of Piperacillin Into the Vitreous After Intravenous Administration

Robinet, A.; Bot, Le; Colin, Joseph; Riché, C

doi:10.1097/00006982-199806000-00006

Cited by 8 publications

(5 citation statements)

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“…Our study found elevated levels of penicillin in the intravitreal space of an inflamed eye following intravenous administration, as seen with piperacillin [10]. This correlates well with studies that have found increased penetration of systemic antibiotics in inflamed eyes versus their non-inflamed counterparts [10,15]. In inflamed eyes, drugs cleared by the posterior route, such as betalactams, demonstrate delayed clearance due to compromise of the RPE pump [15].…”

Section: Discussionsupporting

confidence: 89%

“…Anionic drugs including beta-lactams are subject to accelerated clearance via active transport across the BRB which, in this case, may have further promoted diffusion from the plasma into the vitreous cavity following the concentration gradient [15]. Our study found elevated levels of penicillin in the intravitreal space of an inflamed eye following intravenous administration, as seen with piperacillin [10]. This correlates well with studies that have found increased penetration of systemic antibiotics in inflamed eyes versus their non-inflamed counterparts [10,15].…”

Section: Discussionmentioning

confidence: 49%

“…Similarly, inadequate levels of ampicillin were found in the vitreous of rabbit eyes following administration of intravenous ampicillin of 50 mg/kg [9]. In contrast, in 1998, Robinet et al demonstrated the ability of piperacillin to adequately penetrate the vitreous cavity in humans, at concentrations sufficient to kill Grampositive organisms in inflamed eyes only [10].…”

Section: Discussionmentioning

confidence: 99%

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Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

Thabet

Gottlieb

Hurley

et al. 2021

J Ophthal Inflamm Infect

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Importance The role of systemic antibiotics in the treatment of bacterial endophthalmitis remains controversial. While penicillin is a highly effective antibiotic against bacteria that frequently cause endophthalmitis, the ability of systemically administered Penicillin G to penetrate into the vitreous at adequate therapeutic concentrations has not been studied. Its role in the treatment of endophthalmitis, particularly for bacteria for which it is the antibiotic of choice, therefore remains unknown. Objective We sought to determine whether intravenous administration of Penicillin G leads to adequate therapeutic concentrations in the vitreous for the treatment of bacterial endophthalmitis. Design and setting This study was conducted in an ambulatory setting, at the Ottawa Hospital Eye Institute, a university-affiliated tertiary care center, where a 77-year old gentleman with chronic post-cataract surgery Actinomyces neuii endophathalmitis was treated with intravenous Penicillin G (4 × 106 units every 4 h) and intravitreal ampicillin (5000μg/0.1 m1). Main outcomes and measures Intravitreal concentration of Penicillin G and ampicillin were obtained at the time of intraocular lens removal, measured by high-performance liquid chromatography. Results The intravitreal concentration of penicillin and ampicillin was 3.5μg/ml and 0.3μg/ml, respectively. Both the concentration of penicillin and ampicillin were within the level of detection of their respective assays (penicillin 0.06-5μg/ml, ampicillin 0.12–2.5μg/ml). Conclusion and relevance This study shows that intravenous Penicillin G administered every four-hours allows for adequate intravitreal concentrations of penicillin. Future studies are required to determine if the results of this study translate into improved clinical outcomes.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

Thabet

Gottlieb

Hurley

et al. 2021

J Ophthal Inflamm Infect

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“…Alfaro et al [27] studied the effect of traumatism on the ocular penetration of intravenous ciprofl oxacin in rabbits and pigs, and found that the drug levels increased by three or four times compared with control eyes. In another study, Robinet et al [28] found that drugs which usually do not achieve detectable levels in the human eye, such as piperacillin, could be detected under infl ammatory states. Our study shows that infl ammation leads to a better drug penetration.…”

Section: Infl Ammation Induced By Endotoxin and Changes In Antibioticmentioning

confidence: 99%

Grepafloxacin Concentration in Ocular Tissues after Intravenous Infusion in Rabbits with Intraocular Inflammation

et al. 2005

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Purpose: To determine the penetration of grepafloxacin into ocular tissues during experimental ocular inflammation. Methods: 10 albino and 10 pigmented rabbits underwent a continuous intravenous infusion of the drug 24 h after injecting Salmonella typhimurium toxin intravitreously, creating ocular inflammation. The animals were killed and grepafloxacin levels were determined in plasma and ocular tissues using high performance liquid chromatography. Results: Grepafloxacin levels achieved a steady-state plasma concentration of 1.5 µg/ml. The drug diffused more towards vascularized tissues (chorioretina and iris) in both albino and pigmented rabbits with a tissue/serum ratio higher than 1. Grepafloxacin showed more affinity to pigmented tissue, rising levels of 40,000–50,000 ng/g in the chorioretina and iris in pigmented animals. After inflammation, grepafloxacin intraocular penetration increased in albino animals with levels exceeding the minimum inhibitory concentration for the most common ocular pathogens. Conclusion: Grepafloxacin intraocular penetration is higher in pigmented tissues. Ocular inflammation increases the drug penetration into the vitreous.

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“…Intravitreal antibiotic applications represent a superior means and route for the treatment of endophthalmitis, as the intraocular penetration of systemic antibiotics is poor [2][3][4]. Although vancomycin and aminoglycosides are the two most commonly used antibiotics at present, there has been increasing evidence of resistance to these agents [5].…”

Section: Introductionmentioning

confidence: 99%

Determination of Nontoxic Concentrations of Piperacillin/Tazobactam for Intravitreal Application

Özkırış

Evereklioğlu²,

Kontaş³

et al. 2004

Ophthalmic Res

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Background: To investigate the highest nontoxic intravitreal dose of piperacillin/tazobactam in rabbits. Material and Methods: Forty New Zealand white albino rabbits were used in this study. The rabbits were divided into four equal groups (10 rabbits in each) and the right eyes were treated with 0.1 ml intravitreal injections of 1,000 µg piperacillin/tazobactam in group 1, 500 µg in group 2, 250 µg in group 3, and 100 µg in group 4. The left eyes served as controls and were injected with 0.1 ml of saline solution. Ganzfeld electroretinogram (ERG) was performed on all eyes before and after 4 weeks of intravitreal injections. Then, the rabbits were killed and the eyes were enucleated for histopathological evaluation of the retina. Retinal sections were evaluated by morphometric analyses on cell counts of ganglion cell layer and thickness of the various retinal layers. Results: Baseline ERGs were similar among the groups (p > 0.05). After 4 weeks of injection, there were a reduction of the b-wave amplitude and extension of the b-wave implicit time in photopic and scotopic ERGs in group 1 and group 2 when compared with controls (for each, p < 0.001). Intravitreal injection of 100 and 250 µg piperacillin/tazobactam did not cause any deterioration of the b-wave of ERGs throughout the follow-up period of 4 weeks (for each, p > 0.05). After morphometric analysis of retinal sections in all groups, there were no statistically significant differences in the mean number of surviving ganglion cells, thickness of the whole retina and the inner plexiform layer compared with controls (p > 0.05). Conclusion: 250 µg/0.1 ml piperacillin/tazobactam is the highest nontoxic dose to the normal retinas of adult albino rabbits as intravitreal injection. Piperacillin/tazobactam may be a new, potentially important drug in the treatment of endophthalmitis as it has a broad antimicrobial spectrum.

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Penetration of Piperacillin Into the Vitreous After Intravenous Administration

Cited by 8 publications

References 0 publications

Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

Grepafloxacin Concentration in Ocular Tissues after Intravenous Infusion in Rabbits with Intraocular Inflammation

Determination of Nontoxic Concentrations of Piperacillin/Tazobactam for Intravitreal Application

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