title: Comparison of toxicities of moxifloxacin, cefuroxime, and levofloxacin to corneal endothelial cells in vitro.
abstract: OBJECTIVE
  To evaluate and compare the toxic effects of moxifloxacin, cefuroxime, and levofloxacin on human corneal endothelial cells in vitro and determine the safe intracameral concentrations for them.
  
  
  METHODS
  Tottori University, Tottori, Japan.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Human corneal endothelial cells in culture were exposed to moxifloxacin, cefuroxime, and levofloxacin at concentrations up to 2000 μg/mL. Evaluation of membrane damage was determined by ethidium homodimer-1 uptake and cell viability, by intrinsic esterase activity. The inhibitory effects of the 3 antibiotics on the constitutive secretion of interleukin-6 (IL-6) by human corneal endothelial cells were determined by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The acute effects (6 hour) of the 3 antibiotics on membrane damage and cell death were dose-dependent for moxifloxacin and levofloxacin (≥ 500 μg/mL). For cefuroxime, membrane damage was not observed at 6 hours and only slight damage was detected at 24 hours at concentrations higher than 500 μg/mL. The half maximum inhibitory concentrations on cell viability of moxifloxacin, levofloxacin, and cefuroxime were 487 μg/mL, 578 μg/mL, and 1600 μg/mL, respectively. The inhibitory effects of the 3 antibiotics on the constitutive secretion of IL-6 were observed at 15.6 μg/mL or higher, indicating the antibiotics can impair the secretion of the protective cytokine even at low concentrations.
  
  
  CONCLUSIONS
  Moxifloxacin at more than 500 μg/mL caused damage to the cell membranes of corneal endothelial cells; even higher concentrations decreased cell viability. Considering the lower minimum inhibitory concentration for inhibiting 90% growth by moxifloxacin, intracameral moxifloxacin at 500 μg/mL or less is recommended for prophylactic use.
  
  
  BACKGROUND
  Dr. Inoue is a medical advisor to Alcon Japan Ltd. No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Haruki
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan. Electronic address: dm@grape.med.tottori-u.ac.jp.
authors.forename: Dai
authors.initials: D
authors.lastname: Miyazaki
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Terasaka
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Noguchi
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: From the Division of Ophthalmology and Visual Science (Haruki, Miyazaki, Matsuura, Terasaka, Noguchi, Inoue), Faculty of Medicine, Tottori University, Yonago Tottori, and the Corneal Transplantation Section (Yamagami), University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamagami
mesh_terms: D000900:Anti-Bacterial Agents / Q000633:toxicity*; D002444:Cefuroxime / Q000633:toxicity*; D002470:Cell Survival; D002478:Cells, Cultured; D004305:Dose-Response Relationship, Drug; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D024841:Fluoroquinolones / Q000633:toxicity*; D006801:Humans; D020128:Inhibitory Concentration 50; D015850:Interleukin-6 / Q000378:metabolism; D064704:Levofloxacin / Q000633:toxicity*; D000077266:Moxifloxacin
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; C508600:IL6 protein, human; D015850:Interleukin-6; D064704:Levofloxacin; D002444:Cefuroxime; D000077266:Moxifloxacin