Intravitreal Ceftriaxone in a Rabbit Model

Shockley, Robert K.; Jay, Walter M.; Friberg, Thomas R.; Aziz, Adel M.; Rissing, J. Peter; Aziz, M. Z.

doi:10.1001/archopht.1984.01040031006037

Cited by 22 publications

(4 citation statements)

References 14 publications

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“…That 8 mg of cefoperazone was tolerated compares favorably to ceftriaxone and moxalactam which are tolerated in doses of 5 mg and 2 mg, respectively. (11,15) Since there is variability in the electroretinogram for rabbits, (17,18) we chose two standard deviations in b-wave amplitude to define range of normal. With this we found that one of seven saline-injected eyes had a reduced electroretinogram.…”

Section: Discussionmentioning

confidence: 43%

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Retinal Toxicity of Intravitreal Cefoperazone

O’Hara¹,

Bode²,

Kincaid³

et al. 1986

Journal of Ocular Pharmacology and Therapeutics

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Cefoperazone is a broad spectrum, third-generation cephalosporin with potential usefulness in treating endophthalmitis because of its in vitro activity against Gram-negative organisms.Retinal toxicity was evaluated via serial indirect ophthalmoscopy, electrophysiologic testing and histopathologic examination of 43 Dutch-belted rabbit eyes injected intravitreally with 2, 4, 8, 16 or 32 mg of cefoperazone in a volume of 0.1 cc each. They were compared with seven eyes injected with sterile saline. Results show electroretinographic and histological evidence of retinal toxicity at concentrations of 16 mg or greater, while a single intravitreal dose of 8 mg or less of cefoperazone produced no evidence of retinal toxicity.

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Section: Discussionmentioning

confidence: 43%

“…Eyes receiving up to 20 mg showed normal retinal histology at 14 days. (15) Ten aphakic rabbits were challenged intravitreally with 700 colony-forming units of S_. aureus.…”

Section: Discussionmentioning

confidence: 46%

Retinal Toxicity of Intravitreal Cefoperazone

O’Hara¹,

Bode²,

Kincaid³

et al. 1986

Journal of Ocular Pharmacology and Therapeutics

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“…Ceftriaxone, another antibiotic evaluated from the cephalosporin class, showed a moderate effect on Gram-positive bacteria (only 72.72% of the bacteria were sensitive to the antibiotic) but an excellent effect on Gram-negative bacteria (100% of the bacteria were sensitive to the antibiotic). In the treatment of endophthalmitis, ceftriaxone (at concentrations more than 50 mg/dose) cannot be administered as an intravitreal medication due to ocular toxicity but can by utilized as a systemic adjuvant therapy [48,49]. Systemic delivery of ceftriaxone will produce intravitreal antibiotic levels, which inhibit Streptococci and Enterobacteriaceae but not Staphylococcus aureus [21,50].…”

Section: Discussionmentioning

confidence: 99%

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

Ghita,

Iliescu,

Ghita

et al. 2023

Diagnostics

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Periodic assessment of bacterial contamination is necessary as it allows proper guidance in cases of eye infections through the use of appropriate antibiotics. Due to the extensive use of antibiotic treatment, many strains of the microbiota that cause infections are resistant to the usual ophthalmic antibiotics. The present study provides an updated assessment of the susceptibility of Gram-positive and Gram-negative bacteria found on the ocular surface to the most commonly used antibiotic agents in patients undergoing cataract surgery. A total of 993 patients were included in the study with ages between 44 and 98 years old. Conjunctival cultures were collected 7 days before cataract surgery. The response of Gram-positive and Gram-negative bacteria to various antibiotic classes, such as glycopeptides, cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, phenicols, tetracyclines, rifamycins, macrolides and penicillins, was assessed. From the tested antibiotics, vancomycin had 97.8% efficacy on Gram-positive bacteria. In the cephalosporin category, we observed a high level of resistance of the cefuroxime for both Gram-positive and negative bacteria. Antibiotics that have more than 90% efficacy on Gram-positive bacteria are meropenem, imipenem, netilmicin, amikacin and rifampicin. On Gram-negative bacteria, we found 100% efficacy of all tested fluoroquinolones, i.e., aminoglycosides (except for tobramycin), doxycycline, azithromycin, clarithromycin and chloramphenicol. The current study illustrates patterns of increased resistance in certain bacteria present on the ocular surface to some of the commonly used antibiotics in ophthalmological clinical practice. One such revealing example is cefuroxime, which has been highly used as an intracameral antibiotic for the prevention of bacterial endophthalmitis after cataract surgery.

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“…The clearance of cefuroxime from the vitreous following intravitreal administration is relatively rapid (24 h) when compared to cefazolin (5 days - Fisher et al 1982) and ceftriaxone (72 h - Shockley et al 1984). A biological method was used for antibiotic assay in the two latter studies.…”

Section: Discussionmentioning

confidence: 99%

Intraocular levels of cefuroxime in uninflamed rabbit eyes

Koul

Philipson

et al. 1990

Acta Ophthalmologica

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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.

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Intravitreal Ceftriaxone in a Rabbit Model

Cited by 22 publications

References 14 publications

Retinal Toxicity of Intravitreal Cefoperazone

Retinal Toxicity of Intravitreal Cefoperazone

Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic

Intraocular levels of cefuroxime in uninflamed rabbit eyes

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