title: Aqueous Humor Penetration and Biological Activity of Moxifloxacin 0.5% Ophthalmic Solution Alone or with Dexamethasone 0.1.
abstract: To compare aqueous humor concentrations of topically applied moxifloxacin 0.5% ophthalmic solution alone or in combination with dexamethasone 0.1% and to correlate these concentrations with the minimum inhibitory concentrations (MICs) for common endophthalmitis-causing organisms.
  
  
  
  Sixty-eight patients undergoing routine phacoemulsification with intraocular lens implantation received either moxifloxacin 0.5% alone or moxifloxacin 0.5% combined with dexamethasone. For both groups, 1 drop of the test solution was instilled 4 times daily 1 day preoperatively and 1 drop 1 h preoperatively. An aqueous humor sample obtained immediately before paracentesis was submitted to high-performance liquid chromatography-tandem mass spectrometry to determine the moxifloxacin concentration.
  
  
  
  The mean concentrations of moxifloxacin were 986.6 ng/mL in the moxifloxacin with dexamethasone group and 741.3 ng/mL in the moxifloxacin group (P = 0.13). Moxifloxacin concentrations of all samples exceeded the MICs for Staphylococcus epidermidis, S. aureus, and Streptococcus pneumoniae. All samples in the moxifloxacin with dexamethasone group and 94% in the moxifloxacin group achieved the MIC for Enterococcus species. For quinolone-resistant S. aureus, the MIC was achieved in 29% in the moxifloxacin with dexamethasone group and 9% in the moxifloxacin group (P = 0.06).
  
  
  
  Aqueous humor moxifloxacin concentrations were higher when topically administrated in combination with dexamethasone compared to the moxifloxacin alone. However, this difference was not statistically significant. Nevertheless, the MICs of the most common pathogens associated with endophthalmitis were exceeded in both study groups.
authors.affiliation: 1 Department of Ophthalmology, Federal University of Sao Paulo , Sao Paulo, Brazil .|2 Hospital de Olhos Paulista , Sao Paulo, Brazil .
authors.forename: Rachel L R
authors.initials: RL
authors.lastname: Gomes
authors.affiliation: 2 Hospital de Olhos Paulista , Sao Paulo, Brazil .
authors.forename: Rodrigo Galvão
authors.initials: RG
authors.lastname: Viana
authors.affiliation: 1 Department of Ophthalmology, Federal University of Sao Paulo , Sao Paulo, Brazil .|2 Hospital de Olhos Paulista , Sao Paulo, Brazil .
authors.forename: Luiz Alberto S
authors.initials: LA
authors.lastname: Melo
authors.affiliation: 3 Núcleo de Bioequivalência e Ensaios Clínicos - NuBEC, Federal University of Sao Paulo , Sao Paulo, Brazil .
authors.forename: Alessandro Carvalho
authors.initials: AC
authors.lastname: Cruz
authors.affiliation: 3 Núcleo de Bioequivalência e Ensaios Clínicos - NuBEC, Federal University of Sao Paulo , Sao Paulo, Brazil .
authors.forename: Eunice Mayumi
authors.initials: EM
authors.lastname: Suenaga
authors.affiliation: 4 Department of Ophthalmology, Tufts New England Medical Center , Boston, Massachusetts.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Kenyon
authors.affiliation: 1 Department of Ophthalmology, Federal University of Sao Paulo , Sao Paulo, Brazil .|2 Hospital de Olhos Paulista , Sao Paulo, Brazil .
authors.forename: Mauro
authors.initials: M
authors.lastname: Campos
mesh_terms: D000287:Administration, Topical; D000368:Aged; D001082:Aqueous Humor / Q000187:drug effects* / Q000382:microbiology; D002851:Chromatography, High Pressure Liquid; D003907:Dexamethasone / Q000008:administration & dosage / Q000032:analysis / Q000494:pharmacology*; D016983:Enterococcus / Q000187:drug effects*; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000032:analysis / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000032:analysis / Q000494:pharmacology*; D011446:Prospective Studies; D013210:Staphylococcus / Q000187:drug effects*; D053719:Tandem Mass Spectrometry
chemical_list: D024841:Fluoroquinolones; D009883:Ophthalmic Solutions; D003907:Dexamethasone; D000077266:Moxifloxacin
keywords: antibiotics; aqueous humor; corneal permeability; fluoroquinolone ophthalmic solutions; steroids