Long-Term Potency, Sterility, and Stability of Vancomycin, Ceftazidime, and Moxifloxacin for Treatment of Bacterial Endophthalmitis

Abstract

Vancomycin, ceftazidime, and moxifloxacin prepared in single-use polypropylene syringes retain potency, sterility, and stability out to 24 weeks when stored at -20 °C or -80 °C. The results of this study may have important implications for the current management of endophthalmitis.

Correspondence

“…1 We also showed that concentration, pH, and osmolality remain stable at all temperatures and at all time points up to 24 weeks. The purpose of this letter is to report our 1-year results.…”

Preparation of intracameral antibiotics for injection

“…8 Bacterial killing is dose-dependent, which may have theoretical advantages in the aqueous turnover environment of the anterior chamber. A Ease of preparation may reduce the risk for dilution errors.…”

Ocular Complications of Endocarditis

“…(99) However, the use of intravitreal steroid, dexamethasone in addition to intravitreal antibiotics is recommended for suppression of inflammatory mediators released in the vitreous in bacterial endophthalmitis. (108)(109)(110)(111) The histopathological changes of the eyes treated with intravitreal vancomycin with dexamethasone (0.4 mg/ml) had less conjunctival inflammation, mild iridocyclitis, less vitreous cells, less choroidal vasculitis and retinitis compared to antibiotic treatment alone. (109,110) Topical steroids are also used in patients with anterior focal or diffuse endophthalmitis to reduce the number of inflammatory cells in the anterior chamber, thereby preventing the complications such as formation of synechiae and secondary glaucoma.…”

“…In cases caused by bacteria, intravitreal injection of vancomycin 1mg/0.1ml and ceftazidime 2mg/0.1 ml provides good coverage and avoids the toxicity associated with aminoglycosides. (41,108) Repeated injections may be required since the half-life of these drugs in the vitreous cavity is short. (108) In most cases of fungal endophthalmitis, an intravitreal injection of 5-10 microgram amphotericin B is recommended.…”

“…(41,108) Repeated injections may be required since the half-life of these drugs in the vitreous cavity is short. (108) In most cases of fungal endophthalmitis, an intravitreal injection of 5-10 microgram amphotericin B is recommended. (103) Using amphotericin B in this manner avoids its numerous systemic side effects, but its potential for retinal toxicity should be noted.…”