Aqueous and vitreous penetration of levofloxacin after oral administration.
OBJECTIVE
To investigate the penetration of levofloxacin, an optical S-(-)isomer of ofloxacin, into the aqueous and vitreous humor after oral administration.


METHODS
Randomized, clinical trial comparing tissue levels of levofloxacin after one or two doses 12 hours apart.


METHODS
Forty-five patients undergoing initial vitrectomy between February 1997 and June 1997 at the UIC Eye Center.


METHODS
Aqueous, vitreous, and serum samples were obtained and later analyzed from 45 patients after oral administration of 1 500-mg tablet (group 1, 22 patients) or 2 500-mg tablets (group 2, 23 patients) 12 hours apart before surgery.


METHODS
Aqueous, vitreous, and serum concentrations of levofloxacin (micrograms/milliliter).


RESULTS
Group 1 achieved mean aqueous, vitreous, and serum levels of 0.59 +/- 0.48 microg/ml, 0.32 +/- 0.34 microg/ml, and 4.34 +/- 3.59 microg/ml, respectively. Group 2 achieved mean aqueous, vitreous, and serum levels of 1.90 +/- 0.97 microg/ml, 2.39 +/- 0.70 microg/ml, and 8.02 +/- 3.14 microg/ml.


CONCLUSIONS
Mean inhibitory aqueous and vitreous MIC90 levels were achieved against a majority of ocular pathogens, including Staphylococcus aureus and Staphylococcus epidermidis, Streptococcus pneumoniae (vitreous), Bacillus cereus (vitreous), Haemophilus influenzae, Moraxella catarrhalis, and most gram-negative aerobic organisms except Pseudomonas aeruginosa after two doses given 12 hours apart. Mean MIC90 levels were obtained in the vitreous for a majority of pathogens responsible for traumatic, postoperative, or bleb-related endophthalmitis.
Fiscella
R G
RG
Department of Pharmacy Practice, University of Illinois at Chicago, 60612, USA. fisc@uic.edu
Nguyen
T K
TK
Cwik
M J
MJ
Phillpotts
B A
BA
Friedlander
S M
SM
Alter
D C
DC
Shapiro
M J
MJ
Blair
N P
NP
Gieser
J P
JP
D000284:Administration, Oral; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D001082:Aqueous Humor / Q000378:metabolism*; D001419:Bacteria / Q000187:drug effects; D001682:Biological Availability; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D013607:Tablets; D014018:Tissue Distribution; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism*
D000890:Anti-Infective Agents; D013607:Tablets; D064704:Levofloxacin; D015242:Ofloxacin