Antibiotic-Impregnated Fibrin Glue in Ocular Surgery:In vitro Antibacterial Activity

Abstract

A strategy to reduce postoperative ocular infections might consist in maintaining a high antibiotic concentration in the eye by using a topical slow-release drug formulation. Fibrin glue is widely used in ocular surgery. Vancomycin, teicoplanin, cephalothin and gentamicin were added to a 500 IU/ml thrombin solution, their concentrations in 1 g fibrin glue being 500 µg for vancomycin and 400 µg for the other drugs. The in vitro antibacterial activity of antibiotic-impregnated fibrin glue was evaluated against a recent clinical isolate of Staphylococcus epidermidis. Moreover the antibiotic elution from fibrin discs in saline was assayed for up to 96 h. Fibrin glue properties were maintained when thrombin was reconstituted with a CaCl₂ solution additioned with the antibiotics tested. All antibiotic fibrin mixtures exhibited good antistaphylococcal activity immediately after the preparation. A prolonged inhibition (4 days) of S. epidermidis growth was observed with teicoplanin discs. Gentamicin and teicoplanin levels were higher than those of the other antibiotics. The results suggest that the fibrin glycopeptide and/or gentamicin mixtures can be used, both prophylactically and therapeutically, in ocular surgery.

Fibrin matrices: The versatile therapeutic delivery systems

“…Greco et al [88] entrapped the antibiotics ampicillin, carbenicillin, cefotaxime, ceftazidine, clindamycin, gentamycin, mezlocillin and tobramycin in fibrin clots. The release rates were rapid with more than 50 percent of entrapped antibiotics leaking out in first 24 h and the remaining between 48-96 h. Relatively water insoluble gentamycin and ciprofloxacin were however released more slowly from fibrin matrices with the release lasting for seven days [98]. Kram et al [89] also observed comparable release profiles of entrapped ciprofloxacin, teicoplanin, cefoxitin and gentamycin from FG suspended in normal saline or human serum.…”

“…Marone et al [98] respectively, but were toxic to human dermal fibriblasts only at high concentrations. The nano particle entrapped antibiotics were touted as effective candidates for incorporation within the wound dressing bandages for treatment of microbial infested wounds.…”

“…Transforming Growth Factor β1 [10,11] Platelet-Derived Growth Factors (PDGF-BB, AB) [12,13] Insuline Like Growth Factor (IGF-1) [12] Interleukin-1β [14] Epidermal Growth Factor (EGF) [15] Enzymes/proenzymes Plasminogen [16] Tissue Plasminogen Activator (tPA) [16] Plasminogen Activator Inhibitor [17] Thrombin [18] Neomycin, Gentamicin, Polymyxin E in vitro [81] Cephalotin in vitro and in vivo [82] Cefotaxime in vivo [83] Metranidazole, Bacitracine in vivo [84] Cefoxitin, Gentamicin in vivo [85] Tobramycin in vitro and in vivo [86] Gentamicin derivative in vitro and in vivo [87] Ceftazydime,Tobramycin, Gentamicin,Clindamycin, Ampicillin in vitro [88] Teicoplanin,Ciproflaxacin, Cefoxitin, Gentamicin in vitro [89] Gentamycin derivative in vitro and in vivo [90] Clindamycin, Cefotaxime in vivo [91] Sisomicin in vivo [92] Neomycine in vivo [93] Cifroflaxacin in vitro and in vivo [94] Ampicillin, Debakacin, Gentamicin, Carbenicillin, Ceftazidin, Cefoxitin, Cefoxitin, Polymixin B, Mupirocin, Norflaxacin,Clindamycin,Nitrofurazone in vitro [95] Oflaxacin, Ampicillin, Gentamicin in vitro [96] Abrekacin sulfate in vitro and in vivo [97] Vancomycin, Cephalothin, Gentamicin, Teicoplanin in vitro and in vivo [98] Tetracyclin in vivo [58] Tetracyclin in vitro and in vivo [31] Tetracyclin in vitro [36] Ceftazidime, Moxifloxacin, Lomefloxacin,Vancomycin in vivo [99] Vancomycin in vivo [100] …”

Comparison of the Bacteriostatic Effects, Corneal Cytotoxicity, and the Ability to Seal Corneal Incisions Among Three Different Tissue Adhesives

“…The antibioticimpregnated fibrin glue preparation may significantly reduce the risk of infection and be used as a vehicle to deliver antibiotics to the eye to treat existing ocular infections, and thus, compensate for its drawback as not having antibacterial effects. [22][23][24] However, there are no commercial products on market at present. When choosing tissue adhesives for surgical use, one of the most important concerns is cytotoxicity.…”

Collagen Patches Impregnated with Antimicrobial Agents Have High Local Antimicrobial Efficacy and Achieve Effective Tissue Gluing

“…Common local antimicrobial systems, such as polymethylmethacrylate (PMMA) beads have been in use for several years [1,2]. New technical possibilities and further modifications of therapeutic measures are reflected by the advances made in the current research involving drug delivery sytems (DDS) [3][4][5][6][7][8][9]. Combining hemostatic and antimicrobially effective materials, which can also seal tissues efficiently, is of interest for surgical tissue management.This involves an innovative method in which a simple DDS (collagen with antibiotic/antimicrobial substances) was tested for the first time for its adhesive ability and adhesive strength.…”