Flomoxef sodium and levofloxacin concentrations in aqueous humor.
OBJECTIVE
We intravenously administered flomoxef sodium (FMOX) 120 minutes before cataract surgery, topically administered levofloxacin (LVFX) into the eyes four times at 30-minute intervals before surgery, and measured the aqueous humor concentrations of these agents to investigate their penetration into the aqueous humor and their efficacy in the prevention of postoperative endophthalmitis.


METHODS
Sixty-eight patients who underwent cataract surgery at the Department of Ophthalmology, Yokohama City University School of Medicine, or its affiliate, Kanazawa Hospital, Yokohama, were enrolled in this study. They received one or both of the following: 1.0 g FMOX via a 20-minute intravenous drip and LVFX ophthalmic solution applied four times at 30-minute intervals, both beginning two hours before the operation. Aqueous humor was aspirated from the anterior chamber and assayed for FMOX and LVFX concentrations using high-performance liquid chromatography (HPLC).


RESULTS
The mean intraoperative FMOX and LVFX concentrations in the patients' aqueous humor were 1.21 +/- 0.63 microg/ml and 0.69 +/- 0.47 microg/ml, respectively. These concentrations sufficiently exceeded the MIC90 values against Staphylococcus epidermidis, S. aureus, and Propionibacterium acnes.


CONCLUSIONS
The FMOX and LVFX concentrations in the aqueous humor sampling were adequate to kill bacteria in vitro. These drugs may have efficacy in the prevention of postoperative endophthalmitis in patients undergoing cataract surgery.
Mizuki
Nobuhisa
N
Department of Ophthalmology, Yokohama City University School of Medicine, Kanagawa, Japan. mizunobu@med.yokohama-cu.ac.jp
Watanabe
Yoichiro
Y
Miyamoto
Mariko
M
Iijima
Yasuhito
Y
Takiyama
Naoaki
N
Ito
Yoshiki
Y
Ito
Norihiko
N
Nishida
Tomomi
T
Iwata
Shinko
S
Endo
Yoko
Y
Ito
Daizo
D
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D019072:Antibiotic Prophylaxis; D001082:Aqueous Humor / Q000378:metabolism*; D002386:Cataract / Q000378:metabolism*; D002387:Cataract Extraction; D002511:Cephalosporins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D009877:Endophthalmitis / Q000517:prevention & control; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D009883:Ophthalmic Solutions; D064704:Levofloxacin; D015242:Ofloxacin; C045693:flomoxef