A One-Week Course of Levofloxacin/Dexamethasone Eye Drops: A Review on a New Approach in Managing Patients After Cataract Surgery

Rizzo, Stanislao; Gambini, Gloria; Vico, Umberto De; Rizzo, Clara; Kilian, Raphael

doi:10.1007/s40123-021-00435-1

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…However, it should be noted that some clinical trials indicate the efficacy of compounded preparations. Rizzo et al analyzed the effects of 1-week course of levofloxacin + dexamethasone eye drops in managing patients after cataract surgery [21]. The authors showed that the concentrations of both drugs at the site of action was high enough to prevent infection and inhibit the inflammatory process despite relatively short treatment duration.…”

Section: Opinion Of An Expert In Medical Microbiologymentioning

confidence: 99%

Profilaktyka zakażeń po operacji zaćmy: fluorochinolony i leki przeciwzapalne – pojedynczo czy w preparatach złożonych?

Izdebska,

Wróblewska,

Piechal

et al. 2023

Ophthatherapy

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Operacja zaćmy jest jedną z najczęściej wykonywanych procedur medycznych. Obecnie najczęściej stosowanymi lekami przeciwbakteryjnymi po zabiegach okulistycznych są moksyfloksacyna i lewofloksacyna. Spośród steroidowych leków o działaniu przeciwzapalnym powszechnie wykorzystuje się etabonian loteprednolu lub fosforan deksametazonu. Ze względu na to, że obecnie obowiązujące wytyczne po operacji zaćmy zalecają różne czasy stosowania fluorochinolonów (1–2 tygodnie) i glikokortykosteroidów (3–4 tygodnie), to wydaje się uzasadnione podawanie tych leków w oddzielnych preparatach obecnie dostępnych na rynku. Istnieje bowiem obawa, że stosowanie preparatów złożonych może spowodować zbyt długie przyjmowanie przez pacjenta fluorochinolonu, by utrzymane zostało przeciwzapalne działanie glikokortykosteroidów w miejscu operowanym, to zaś może doprowadzić do selekcji szczepów opornych i zwiększa ryzyko działań niepożądanych.

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Section: Opinion Of An Expert In Medical Microbiologymentioning

confidence: 99%

Profilaktyka zakażeń po operacji zaćmy: fluorochinolony i leki przeciwzapalne – pojedynczo czy w preparatach złożonych?

Izdebska,

Wróblewska,

Piechal

et al. 2023

Ophthatherapy

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“…Indeed, apart from instances of DEX being loaded into solid DDS like tablets or intravitreal implants [ 19 ], the most commonly used dosage forms currently available on the market are eye drops in which the drug is in suspension, either alone or in the presence of other active ingredients (e.g., levofloxacin, tobramycin, netilmicin). Formulations to date on the market have a 0.1% w/v of DEX, and the usual dose of DEX-based eye drops is one drop per eye repeated every 4 h. The administration of eye drops formulations is particularly challenging [ 20 ] due to the presence of static ocular barriers, such as anatomical (cornea, sclera, retina), haemato-aqueous, and haemato-retinal barriers. Moreover, the presence of dynamic barriers, such as the nasolacrimal duct, blinking reflex, and the low receiving volume of the conjunctival sac (20–50 µL), greatly reduce the bioavailability of drugs at the ocular AS [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The use of eye drops can represent an obstacle for these patients, given the difficulty in instilling the drops in multiple and repeated administrations at different times of the day. Thus, there is a need to formulate a safe, manageable, and effective product that can ensure the resolution of inflammation and optimal adherence to therapy [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Chitosan and Anionic Solubility Enhancer Sulfobutylether-β-Cyclodextrin-Based Nanoparticles as Dexamethasone Ophthalmic Delivery System for Anti-Inflammatory Therapy

Racaniello,

Balenzano,

Arduino

et al. 2024

Pharmaceutics

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Cataract surgery interventions are constantly increasing, particularly among adult and elderly patients. This type of surgery can lead to inflammatory states of the ocular anterior segment (AS), usually healed via postoperative treatment with dexamethasone (DEX)-containing eye drops. The application of eye drops is challenging due to the high number of daily administrations. In this study, mucoadhesive nanoparticles (NPs) were formulated to improve the residence time of DEX on the corneal mucosa, enhancing the drug’s solubility and bioavailability. The NPs were generated using an ionotropic gelation technique, exploiting the interaction between the cationic group of chitosan (CS) and the anionic group of sulfobutylether-β-cyclodextrin (SBE-β-CD). The formation of the inclusion complex and its stoichiometry were studied through phase solubility studies, Job’s plot method, and Bi-directional transport studies on MDCKII-MDR1. The obtained NPs showed good chemical and physical characteristics suitable for drug loading and subsequent testing on animal mucosa. The DEX-loaded CS/SBE-β-CD NPs exhibited a prolonged residence time on animal mucosa and demonstrated enhanced drug permeability through the corneal membrane, showing a sustained release profile. The developed NPs posed no irritation or toxicity concerns upon local administration, making them an optimal and innovative drug delivery system for inflammatory AS diseases treatment.

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“…Introducing routine prophylactic antibiotics following cataract surgery has been associated with a significant decrease in endophthalmitis rates. Intracameral and topical antibiotics are currently utilized to prevent this condition, depending on the surgeon's preference and local resistance patterns ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Experience of Using a Combination of Dexamethasone and Levofloxacin After Cataract Surgery

Kuzman,

Gabric,

Meter

et al. 2024

Med Arch

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Background: Where routine prophylactic antibiotics have been adopted following cataract surgery, rates of endophthalmitis have been decreasing. Intracameral and topical antibiotics are currently used to prevent endophthalmitis after cataract surgery. When applying topical antibiotics, there are different recommendations on the frequency and duration of therapy. The development of bacterial resistance to the excessive and long-term use of antibiotics is a growing problem worldwide. The goal is to achieve a good antibiotic effect with the shortest possible use of antibiotics. Objective: The aim of this study was to compare the effectiveness of a new combination therapy of dexamethasone and levofloxacin for seven days after cataract surgery with the previous regimen of dexamethasone, neomycin sulfate, and polymyxin B, which was given for 21 days. Methods: A retrospective analysis of medical records and administered a questionnaire was conducted to assess the effectiveness of postoperative therapy in our cataract surgery patients. The study involved 52 patients who underwent surgery within the last year, performed by a single surgeon at our institution. The findings can help us improve the quality of care we provide and optimize our patients' overall quality of life. Results: We conducted an in-depth study on 52 individuals who underwent cataract surgery at our institution. The prescribed therapeutic regimen for the participants included administering Ducressa solution four times daily for the first seven days and Maxidex solution three times daily for the subsequent 14 days. The study found that none of the participants experienced complications after surgery, and all found it easy to instill the medication. The prescribed regimen effectively managed the postoperative recovery of the participants, and the medication was well-tolerated. Conclusion: Our research found that a new combination of levofloxacin and dexamethasone, when used topically, may require a shorter treatment period, reducing the risk of antibiotic resistance and providing a safe alternative for endophthalmitis prevention.

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A One-Week Course of Levofloxacin/Dexamethasone Eye Drops: A Review on a New Approach in Managing Patients After Cataract Surgery

Cited by 9 publications

References 30 publications

Profilaktyka zakażeń po operacji zaćmy: fluorochinolony i leki przeciwzapalne – pojedynczo czy w preparatach złożonych?

Profilaktyka zakażeń po operacji zaćmy: fluorochinolony i leki przeciwzapalne – pojedynczo czy w preparatach złożonych?

Chitosan and Anionic Solubility Enhancer Sulfobutylether-β-Cyclodextrin-Based Nanoparticles as Dexamethasone Ophthalmic Delivery System for Anti-Inflammatory Therapy

Clinical Experience of Using a Combination of Dexamethasone and Levofloxacin After Cataract Surgery

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