Subject(s)
Anti-Bacterial Agents , Ciprofloxacin , Drug Utilization Review , Endophthalmitis/epidemiology , Eye Infections, Bacterial/epidemiology , Ofloxacin , Postoperative Complications , Endophthalmitis/drug therapy , Endophthalmitis/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/microbiology , Humans , Incidence , Phacoemulsification , Prevalence , Retrospective Studies , Utah/epidemiologyABSTRACT
PURPOSE: To investigate the absorption of moxifloxacin into human aqueous humor after administration of moxifloxacin hydrochloride ophthalmic solution, 0.5% as base. METHODS: Cataract patients were randomly allocated to receive 1 drop every 15 minutes for 4 doses before surgery (group 1) or 1 drop 4 times per day on the day before surgery plus the same preoperative regimen as group 1 (group 2). The last dose was administered 0.25, 0.50, 1, 2, or 3 hours before aqueous humor sampling. Samples from 30 patients per group were analyzed by a validated HPLC/MS/MS method. RESULTS: For group 1, the mean +/- SD C(max) was 1.50 +/- 0.75 microg/mL and occurred at 0.5 hour after dosing. The mean C(max) for group 2 was 1.74 +/- 0.66 microg/mL and was reached at 1 to 2 hours. Mean AUC(0-3h) for groups 1 and 2 were 3.16 +/- 0.29 and 4.41 +/- 0.48 microg.h/mL, respectively. The difference in AUC(0-3h) was statistically significant (P = 0.04), but the difference in Cmax was not. CONCLUSIONS: Topical moxifloxacin was well absorbed. Maximum moxifloxacin concentrations were approximately 30 times higher than the median MICs for common pathogens in bacterial endophthalmitis, indicating that either regimen may provide sufficient concentrations to prevent postoperative endophthalmitis.
Subject(s)
Antibiotic Prophylaxis , Aqueous Humor/metabolism , Aza Compounds/pharmacokinetics , Endophthalmitis/prevention & control , Quinolines/pharmacokinetics , Absorption , Aged , Aged, 80 and over , Aza Compounds/administration & dosage , Cataract Extraction/adverse effects , Chromatography, High Pressure Liquid , Dose-Response Relationship, Drug , Endophthalmitis/etiology , Endophthalmitis/metabolism , Female , Fluoroquinolones , Follow-Up Studies , Humans , Male , Middle Aged , Moxifloxacin , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/pharmacokinetics , Preoperative Care , Quinolines/administration & dosageABSTRACT
PURPOSE: To evaluate the in vivo efficacy of topical moxifloxacin 0.5% versus ciprofloxacin 0.3% in the treatment of Pseudomonas aeruginosa keratitis and topical moxifloxacin 0.5% versus vancomycin 50 mg/mL in the treatment of ciprofloxacin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) keratitis in rabbits. METHODS: Experimental bacterial keratitis was induced in rabbits by corneal intrastromal injection. Infection proceeded for 12 hours, after which topical antibiotics were applied hourly for 12 hours. Corneal homogenates were plated with serial dilutions for quantitative bacteriology. RESULTS: Both moxifloxacin and ciprofloxacin performed significantly better than control in the treatment of Pseudomonas aeruginosa keratitis (P=0.0046 and 0.0069, respectively); there were no significant differences between these 2 drugs in bactericidal activity (P=0.1120). Moxifloxacin performed significantly better than control in the treatment of ciprofloxacin-resistant MRSA (P=0.0321) keratitis, and vancomycin showed a trend toward statistical significance in performing better than control (P=0.0576); there were no significant differences between these 2 drugs in bactericidal activity (P=0.5205). CONCLUSIONS: Topical moxifloxacin 0.5% and ciprofloxacin 0.3% have similar efficacy in the treatment of Pseudomonas aeruginosa keratitis in rabbits. Topical moxifloxacin 0.5% and vancomycin 50 mg/mL have similar efficacy in the treatment of ciprofloxacin-resistant MRSA keratitis in rabbits. These results suggest a potential value for topical moxifloxacin as a broad-spectrum agent in the treatment of bacterial keratitis.
