Intraocular levels of cefuroxime in uninflamed rabbit eyes

Abstract

Intraocular levels of cefuroxime following subconjunctival, intravitreal and combined intravitreal and intravenous administration were determined in uninflamed rabbit eyes. Intraocular levels of the antibiotic were assayed by a biological method. Penetration of cefuroxime into the vitreous following subconjunctival administration was poor. Subconjunctival administration produced higher levels of cefuroxime in the aqueous when compared to parenteral administration alone. Higher levels of cefuroxime were achieved both in the aqueous and in the vitreous after an intravitreal injection. Intravitreal injection of 100 and 1000 micrograms cefuroxime produced intravitreal levels close to the minimum inhibitory concentration (MIC) for most ocular pathogens up to 24 h after drug administration. Intravenous supplementation did neither enhance the intraocular levels nor did it delay the clearance of the intravitreally injected antibiotic. Mild histopathological changes were seen with equal frequency both in the control and the test eyes and are attributed to the sampling techniques. Electroretinography (ERG) showed no definite changes suggestive of retinal toxicity up to 55 days after intravitreal administration.

Perspectives on antibiotics for postoperative endophthalmitis prophylaxis: Potential role of moxifloxacin

“…However, few studies have investigated the potential ocular toxicity of intracameral cefuroxime. 20,28,29 In addition, widespread use of intracameral cefuroxime for cataract surgery endophthalmitis prophylaxis poses a potential safety concern with respect to the risk for systemic b-lactam hypersensitivity reactions. Various studies 20,30 estimate that the prevalence of penicillin allergy ranges between 1% and 10%.…”

Toxicity to the macula after using small doses cefuroxime for phacoemulsification and vitrectomy combined surgery

“…Intravitreal injection of 0.1-1 mg cefuroxime in uninflamed rabbit eyes produced intravitreal levels close to the minimum inhibitory concentration for most ocular pathogens up to 24h after drug administration. Mild histopathological changes were seen, however, electroretinography showed no definite changes suggestive of retinal toxicity in rabbit eyes [8] . Some reports have shown a long-term deleterious effect on the retina from injection of cefuroxime sodium in high concentration [4,9] .…”

In vitro study on the effect of antibiotic combinations on Staphylococcus epidermidis biofilms

“…17 Vancomycin was used in concentration of 1 mg/0.1 ml in this study for sensitivity, which is an intravitreal dose vancomycin as suggested by EVS group in 1995. According to Koul et al 18 reduction of endophthalmitis by cefuroxime can be contributed to its anti-adhesion effect. In ESCRS, five-to six-times decrease in endophthalmitis was observed after using the intracameral injection of cefuroxime (1 mg in 0.1 ml in normal saline) at the end of cataract surgery.…”