Topical 0.5% moxifloxacin prevents endophthalmitis in an intravitreal injection rabbit model.
BACKGROUND
Intravitreal injections for the treatment of retinal disease have increased the risk of endophthalmitis. We developed a rabbit model to investigate whether topical 0.5% moxifloxacin could prevent endophthalmitis after an intravitreal injection.


METHODS
A rabbit model of intravitreal injection to produce endophthalmitis was developed by injecting triamcinolone into the vitreous through a depot of subconjunctival Staphylococcus aureus (10(7) cfu). Endophthalmitis was evaluated clinically and confirmed by culture. The model was tested with a commercially available brand of topical 0.5% moxifloxacin (N = 10) and saline (N = 10). In brief, after bacterial subconjunctival challenge, a topical treatment was administered every 15 min for 1 h. Immediately thereafter, triamcinolone was injected into the vitreous through the treated bacterial depot. Topical 0.5% moxifloxacin and saline were administered QID over the next 72 h. All rabbits were examined daily, euthanized, and tested for viable bacteria when clinical signs of endophthalmitis were observed.


RESULTS
Anti-infective treatment with topical 0.5% moxifloxacin prevented the development of endophthalmitis (0/9 rabbits), compared to topical saline (6/10 rabbits; P = 0.01; power = 0.99).


CONCLUSIONS
Topical 0.5% moxifloxacin provided effective prophylaxis to prevent endophthalmitis after an intravitreal injection of triamcinolone. This unique model may prove valuable to demonstrate prophylaxis for other anti-infectives at an intravitreal injection site.
Kowalski
Regis P
RP
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. kowalskirp@upmc.edu
Romanowski
Eric G
EG
Mah
Francis S
FS
Yates
Kathleen A
KA
Gordon
Y Jerold
YJ
D000287:Administration, Topical; D000818:Animals; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001372:Aza Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D003231:Conjunctivitis / Q000188:drug therapy / Q000209:etiology; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D024841:Fluoroquinolones; D007267:Injections; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control; D014822:Vitreous Body / Q000382:microbiology
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; D011804:Quinolines; D000077266:Moxifloxacin