Experimental pseudomonal posttraumatic endophthalmitis in a swine model. Treatment with ceftazidime, amikacin, and imipenem.
OBJECTIVE
To compare the intravitreal efficacy of three separately administered antibiotics (imipenem, ceftazidime, and amikacin) in limiting the intraocular inflammation and tissue destruction caused by posttraumatic pseudomonal endophthalmitis.


METHODS
Thirty-three Yorkshire pigs each received a surgically induced scleral injury to the right eye. After repair, each eye was injected with 22,000 colony-forming units of live Pseudomonas aeruginosa. Pigs then were randomly grouped into a natural-history-of-infection group in which no treatment was given (n = 9) or into groups treated with the following: intravitreal imipenem (n = 6), ceftazidime (n = 6), amikacin (n = 6), or normal saline (n = 6). Pigs then were observed clinically for 18-24 hours after surgery and enucleated for histopathologic examination.


RESULTS
Clinical examinations revealed significantly less posterior segment inflammation in pigs treated with amikacin and imipenem than in pigs in the natural history or saline control groups, based on the Wilcoxon rank sum test (P < .05). Histopathologic examinations showed similar results, with less intraocular inflammation and retinal destruction in pigs treated with amikacin and imipenem, whereas the inflammation in pigs treated with ceftazidime did not differ significantly from that in control pigs.


CONCLUSIONS
Intravitreal antibiotic treatment with imipenem or amikacin appears to limit intraocular inflammation and retinal tissue damage when given early in the course of posttraumatic pseudomonal endopthalmitis. Results with ceftazidime are less conclusive.
Alfaro
D V
DV
Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799, USA.
Hudson
S J
SJ
Kasowski
E J
EJ
Barton
C P
CP
Brucker
A J
AJ
Lopez
J D
JD
Beverly
D T
DT
King
L P
LP
D000583:Amikacin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D004195:Disease Models, Animal; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D015807:Eye Injuries, Penetrating / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D005500:Follow-Up Studies; D015378:Imipenem / Q000627:therapeutic use; D007267:Injections; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012590:Sclera / Q000293:injuries*; D013552:Swine; D013845:Thienamycins / Q000627:therapeutic use; D014822:Vitreous Body / Q000187:drug effects / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D015378:Imipenem; D000583:Amikacin; D002442:Ceftazidime