Aims: To determine the pharmacokinetics of moxifloxacin, a new generation fluoroquinolone, in the anterior chamber of the human uninflamed eye. Methods: 35 patients undergoing cataract surgery received two doses of 400 mg of oral moxifloxacin with a 12 hour interval and were divided into six groups. Moxifloxacin levels in aqueous humour and serum were determined by a microbiological agar well diffusion technique at 2, 4, 6, 8, 10, and 12 hours after the second dose in each group respectively. Results: Mean moxifloxacin levels in the anterior chamber were 1.20 (SD 0.35) mg/ml at the 2 hours group, 1.22 (0.48) mg/ml at the 4 hours group, 1.20 (0.45) mg/ml at the 6 hours group, 1.58 (0.38) mg/ ml at the 8 hours group, 1.37 (0.44) mg/ml at the 10 hours group, and 1.23 (0.55) mg/ml at the 12 hours group. The mean ratio of aqueous to serum moxifloxacin level was 38%. Conclusion: Moxifloxacin penetrates well into the anterior chamber of the human uninflamed eye after oral administration, reaching early significant levels, which are maintained for at least 12 hours and are much higher than the MIC 90 values of Gram positive and Gram negative pathogens commonly implicated in intraocular infections with the exceptions of fluoroquinolone resistant staphylococci, MRSA, and Pseudomonas aeruginosa. Bacterial endophthalmitis is one of the most serious complications following intraocular operations and penetrating ocular trauma. In the first setting the commonest micro-organisms involved are either Gram positive (Staphylococcus epidermidis, Staphylococcus aureus, streptococci, Propionibacterium acnes) or Gram negative (Pseudomonas aeruginosa, Haemophilus influenza, and Serratia marcescens) while in post-traumatic endophthalmitis there is significant involvement of Bacillus cereus and Staphylococcus aureus.

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A 17-year-old girl with Cogan's syndrome is described. Total and irreversible hearing loss occurred which was unresponsive to corticosteroids and immunosuppressive therapy. The girl died a year later from subarachnoid haemorrhage. The lethal prognosis in Cogan's syndrome despite the available treatment is emphasized.

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