Antibiotic Concentration in Ocular Tissues

Bloome, Michael A.; Golden, Bruce; McKee, Albert P.

doi:10.1001/archopht.1970.00990030080015

Cited by 38 publications

(4 citation statements)

References 9 publications

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“…3,12,[52][53][54][55][56] The effectiveness of systemic antibiotic therapy in bacterial keratitis has not been well studied but would likely depend on adequate drug delivery either via the tear film, through the aqueous humor and/or via the corneal blood vessels, if present. 57 Cephalosporins and doxycycline have been previously detected in the tear film and the cornea following systemic administration. 55,58,59 Nevertheless, topical antibiotic therapy for corneal ulcers is considered most effective and systemic administration may be of limited value in avascular corneas.…”

Section: Discussionmentioning

confidence: 99%

Melting corneal ulcers (keratomalacia) in dogs: A 5‐year clinical and microbiological study (2014–2018)

Tsvetanova

Powell²,

Tsvetanov

et al. 2021

Veterinary Ophthalmology

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Objectives: To identify bacterial microorganisms associated with canine keratomalacia, review their antimicrobial sensitivity, and evaluate clinical outcomes compared to results of microbial culture. Methods: Retrospective analysis of clinical records of dogs diagnosed with a melting corneal ulcer presented to a referral hospital in Hertfordshire, UK between 2014 and 2018. Results: One hundred and ten melting corneal ulcers were sampled in 106 dogs.The most common pure bacterial isolate was Pseudomonas aeruginosa (n = 26) followed by β-hemolytic Streptococcus (n = 12). Melting corneal ulcers that cultured coagulase-positive Staphylococcus, coliform bacteria, Pasteurella multocida, Enterococcus, and Streptococcus viridans presented in smaller numbers and were analyzed together (n = 16). Multiple cultures were identified in nine cases (n = 9). Forty-seven cultures yielded no bacterial growth (n = 47). The susceptibility to fluoroquinolones remained high with the exception of β-hemolytic Streptococci. There was no significant difference in the ulcer severity at presentation in regard to the cultured bacteria. Overall, 63 eyes (57%) received surgical grafting in addition to medical treatment. In 14 cases (13%), the progression of corneal melting despite medical ± surgical treatment resulted in enucleation. Fifty-seven percent (8/14) of the enucleated eyes cultured pure Pseudomonas aeruginosa isolates. In contrast, all β-hemolytic Streptococcus-associated ulcers healed. Conclusions: The most common bacterial species associated with canine keratomalacia were Pseudomonas aeruginosa and β-hemolytic Streptococcus. Because of the variation in antibacterial sensitivity between these two species, bacterial culture and sensitivity testing should be performed in all dogs presenting with keratomalacia.Melting corneal ulcers associated with pure Pseudomonas infection were significantly more likely to result in globe loss than melting corneal ulcers associated with other cultures.

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Section: Discussionmentioning

confidence: 99%

Melting corneal ulcers (keratomalacia) in dogs: A 5‐year clinical and microbiological study (2014–2018)

Tsvetanova

Powell²,

Tsvetanov

et al. 2021

Veterinary Ophthalmology

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“…The antibiotic activity is smaller than the total antibiotic activity would indicate (Bloome et al 1970). This reduction of biological activity is caused by binding of the antibiotic to plasma and tissue proteins.…”

Section: Discussionmentioning

confidence: 96%

Cloxacillin Distribution in the Rabbit Eye After Intravenous Injection

Salminen

1978

Acta Ophthalmologica

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Distribution of isotopically labelled and intravenously injected cloxacillin was studied in rabbit eye. The antibiotic concentration determined by liquid scintillation counting proved to be a reliable measure of the total antibiotic concentration when controlled by microbiological assay. In the rabbit eye after an intravenous injection of 50 mg/kg of cloxacillin sodium, longlasting antibiotic concentration regarded as therapeutic against penicillinase producing staphylococci was obtained in all vascularized ocular structures and in the cornea. The antibiotic present in the iris and ciliary body, and in the retina and choroid preparations, proved to be partly intravascular, whereas it penetrated better into the extravascular tissue compartment of the sclera and limbal area. Cloxacillin failed to achieve a therapeutic antibiotic concentration in the vitreous body and in the lens. Administration of probenecid had an enhancing effect on ocular cloxacillin concentration allowing improved drug diffusion into the eye by means of an elevated plasma concentration. No specific ocular effect of probenecid was noticed. Therapeutic concentration of cloxacillin in the aqueous humour, otherwise barely achieved, was more satisfactorily obtained with a previous injection of probenecid.

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“…In both cases, vitreal concentrations were below known therapeutic concentrations [6,7]. A rabbit study evaluated the total concentration of penicillin in ocular tissues and found extremely high levels of penicillin in all ocular tissues except the lens and vitreous [8]. Similarly, inadequate levels of ampicillin were found in the vitreous of rabbit eyes following administration of intravenous ampicillin of 50 mg/kg [9].…”

Section: Discussionmentioning

confidence: 99%

Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

Thabet

Gottlieb

Hurley

et al. 2021

J Ophthal Inflamm Infect

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Importance The role of systemic antibiotics in the treatment of bacterial endophthalmitis remains controversial. While penicillin is a highly effective antibiotic against bacteria that frequently cause endophthalmitis, the ability of systemically administered Penicillin G to penetrate into the vitreous at adequate therapeutic concentrations has not been studied. Its role in the treatment of endophthalmitis, particularly for bacteria for which it is the antibiotic of choice, therefore remains unknown. Objective We sought to determine whether intravenous administration of Penicillin G leads to adequate therapeutic concentrations in the vitreous for the treatment of bacterial endophthalmitis. Design and setting This study was conducted in an ambulatory setting, at the Ottawa Hospital Eye Institute, a university-affiliated tertiary care center, where a 77-year old gentleman with chronic post-cataract surgery Actinomyces neuii endophathalmitis was treated with intravenous Penicillin G (4 × 106 units every 4 h) and intravitreal ampicillin (5000μg/0.1 m1). Main outcomes and measures Intravitreal concentration of Penicillin G and ampicillin were obtained at the time of intraocular lens removal, measured by high-performance liquid chromatography. Results The intravitreal concentration of penicillin and ampicillin was 3.5μg/ml and 0.3μg/ml, respectively. Both the concentration of penicillin and ampicillin were within the level of detection of their respective assays (penicillin 0.06-5μg/ml, ampicillin 0.12–2.5μg/ml). Conclusion and relevance This study shows that intravenous Penicillin G administered every four-hours allows for adequate intravitreal concentrations of penicillin. Future studies are required to determine if the results of this study translate into improved clinical outcomes.

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Antibiotic Concentration in Ocular Tissues

Cited by 38 publications

References 9 publications

Melting corneal ulcers (keratomalacia) in dogs: A 5‐year clinical and microbiological study (2014–2018)

Melting corneal ulcers (keratomalacia) in dogs: A 5‐year clinical and microbiological study (2014–2018)

Cloxacillin Distribution in the Rabbit Eye After Intravenous Injection

Intravenous administration of Penicillin results in therapeutic intravitreal levels in chronic postoperative endophthalmitis

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