Calculation of AQCmax: comparison of five ophthalmic fluoroquinolone solutions*.
ABSTRACT Objective: Ocular tissue penetration of five different ophthalmic fluoroquinolone solutions in the rabbit eye was measured and evaluated by an index of the maximum aqueous concentration (AQCmax).


METHODS
Moxifloxacin 0.5% (MFLX), levofloxacin 0.5% (LVFX), gatifloxacin 0.3% (GFLX), ofloxacin 0.3% (OFLX), or tosufloxacin tosilate 0.3% (TFLX) were instilled into the eyes of white rabbits every 15 min for a total of three doses. Aqueous humor, cornea, iris/ciliary body and vitreous body were collected 10 to 240 min after instillation and drug concentrations were measured by high-performance liquid chromatography.


RESULTS
The concentration of MFLX was the highest in each tissue, with maximum concentrations of MFLX in the aqueous humor (10.16 +/- 1.59 microg/mL) at 30 min after instillation, cornea (156.07 +/- 95.97 microg/g) and iris/ciliary body (11.92 +/- 4.00 microg/g) at 10 min after instillation, and vitreous body (0.099 +/- 0.033 microg/mL) at 30 min after instillation. The concentration of TFLX was the lowest in each tissue, with LVFX, GFLX, and OFLX sharing the mid-ranks. AQCmax : MIC(90) ratio for S. aureus was 150.67 for MFLX, 10.6 for LVFX, 9.69 for GFLX, 3.48 for OFLX, and could not be determined for TFLX.


CONCLUSIONS
AQCmax is a useful pharmacokinetic parameter for determining the therapeutic efficacy of an ophthalmic antibiotic, especially when combined with MIC(90) values for intraocular pathogens. C(max) of MFLX ophthalmic solution was superior in all tissues (cornea, aqueous humor, iris/ciliary body and vitreous body) among the five ophthalmic solutions studied, exceeding the MIC(90) of S. aureus in all tissues, and MIC(90)s of S. epidermidis, B. cereus, and P. acnes in aqueous humor, cornea, and iris/ciliary body. AQCmax was approximately proportional to C(max) in iris/ciliary body and vitreous, and may be used in combination with MIC(90)s as an index to predict the most appropriate dose and frequency of ophthalmic antibiotics in conjunction with other PK/PD parameters. This study may provide the groundwork for calculation of AQCmax in humans.
Fukuda
Masamichi
M
Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan. fukuda@kanazawa-med.ac.jp
Sasaki
Hiroshi
H
D000818:Animals; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005123:Eye / Q000378:metabolism / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy; D024841:Fluoroquinolones / Q000493:pharmacokinetics* / Q000494:pharmacology; D009883:Ophthalmic Solutions / Q000493:pharmacokinetics* / Q000494:pharmacology; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D009883:Ophthalmic Solutions