Vitreous Penetration of Topical Moxifloxacin and Gatifloxacin in Humans

Costello, Patrick; Bakri, Sophie J.; Beer, Paul M.; Singh, Ravinder J.; Falk, Naomi S.; Peters, George B.; Melendez, Jose

doi:10.1097/00006982-200602000-00012

Cited by 53 publications

(31 citation statements)

References 20 publications

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“…The achieved concentrations after topical application in eye compartments were considerably lower than those reported in the present study in rabbits [21,22]. In another study [1], patients undergoing cataract surgery received two oral doses of 400 mg moxifloxacin with a 12-h interval between them.…”

Section: Discussioncontrasting

confidence: 80%

Pharmacokinetics of intravenously administered moxifloxacin in eye compartments: an experimental study

Tzepi

Vergados

Kanellakopoulou

et al. 2009

International Journal of Antimicrobial Agents

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Section: Discussioncontrasting

confidence: 80%

Pharmacokinetics of intravenously administered moxifloxacin in eye compartments: an experimental study

Tzepi

Vergados

Kanellakopoulou

et al. 2009

International Journal of Antimicrobial Agents

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“…Once an organism reaches the vitreous, however, topical application of antibiotics is probably not efficacious. 50 In vitro susceptibility data and animal studies cannot be translated uniformly into in vivo efficacy because of additional factors such as anatomic location and pharmacodynamics. Many surgeons have begun dosing the fourth-generation fluoroquinolones on the day of surgery only, although based on the levels achieved and the kill-curve kinetics, dosing 1 to 3 days before surgery might be more protective.…”

Section: Uncertainty In Methods Of Endophthalmitis Prophylaxismentioning

confidence: 99%

Intracameral antibiotics: Questions for the United States based on prospective studies

Liesegang¹

2008

Journal of Cataract and Refractive Surgery

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Recent prospective studies from Europe suggest the use of intracameral antibiotics for prophylaxis of endophthalmitis, although the studies did not make a comparison with the most common United States prophylaxis techniques. Thus, the European studies as well as the present literature were reviewed in an attempt to place the European studies in perspective with regard to the present U.S. protocol and the available literature. There is no worldwide-established approach to prophylaxis of endophthalmitis. In the absence of a strong evidence-based approach most surgeons use surrogate studies to support their techniques and mold their opinions based on their interpretation of the literature and when they believe organisms causing endophthalmitis enter the eye. The review showed that preoperative topical antibiotics limit the number of bacteria on the ocular surface at surgery and postoperative topical antibiotics are most appropriate to address postoperative inoculation until the wound is sealed (with no tapering). Whereas intracameral antibiotic injection may be an appropriate route of administration to address inoculation occurring at the time of surgery, more research on safety and effectiveness is needed before we expose the millions of eyes having cataract surgery each year. A multipronged approach to limit endophthalmitis risk is also needed, with antibiotics as only part of the strategy.

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“…Gatifloxacin administered orally prior to pars plana vitrectomy resulted in aqueous and vitreous concentrations that were above the MIC 90 for the most common endophthalmitis pathogens (Hariprasad, et al, 2003). However, topical administration of moxifloxacin and gatifloxacin resulted in vitreous concentrations of each antibiotic that were below the MIC 90 for common endophthalmitis pathogens (Costello, et al, 2006). Compared with other quinolones, moxifloxacin has been reported to penetrate more effectively into intraocular tissues following topical administration (Robertson, et al 2005;Yagci, et al, 2006).…”

Section: Therapeutic Challengesmentioning

confidence: 99%

Bacterial endophthalmitis: Therapeutic challenges and host–pathogen interactions

Callegan

Gilmore

Gregory

et al. 2007

Progress in Retinal and Eye Research

156

153

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Endophthalmitis is an infection of the posterior segment of the eye that frequently results in loss of vision. This devastating result occurs despite prompt and often aggressive therapeutic and surgical intervention. Over the past decade, research has centered on determining the bacterial and host factors involved in this potentially blinding disease. The initial focus on the bacterial factors responsible for intraocular virulence has recently expanded into analysis the inflammatory response to infection, including the molecular and cellular interactions between the pathogen and host. This review discusses the epidemiology and therapeutic challenges posed by endophthalmitis, as well as recent findings from the analysis of interactions between the host and pathogen. Based on these findings, a model for the pathogenesis of endophthalmitis is presented. A more comprehensive understanding of the molecular and cellular interactions taking place between pathogen and host during endophthalmitis will expose possible therapeutic targets designed to arrest the infection and prevent vision loss.

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Vitreous Penetration of Topical Moxifloxacin and Gatifloxacin in Humans

Abstract: Both topical moxifloxacin 0.5% and gatifloxacin 0.3% penetrated the vitreous in the uninflamed eye, but the vitreous concentrations attained were all lower than the 90% minimum inhibitory concentration for the commonest bacterial pathogens causing acute postoperative endophthalmitis.

Cited by 53 publications

References 20 publications

Pharmacokinetics of intravenously administered moxifloxacin in eye compartments: an experimental study

Pharmacokinetics of intravenously administered moxifloxacin in eye compartments: an experimental study

Intracameral antibiotics: Questions for the United States based on prospective studies

Bacterial endophthalmitis: Therapeutic challenges and host–pathogen interactions

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