Ocular Penetration of Intravenously Administered Colistin in Rabbit Uveitis Model

Özçimen, Muammer; Özçimen, Serap; Sakarya, Yaşar; Sakarya, Rabia; Göktaş, Sertan; Alpfidan, İsmail; Erdoğan, Erkan

doi:10.1089/jop.2014.0027

Cited by 8 publications

(8 citation statements)

References 28 publications

(26 reference statements)

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“…[ 8 ] Intravenous colistin has been shown to have poor ocular penetration in rabbits, with concentrations in the aqueous and vitreous not reaching therapeutically relevant levels after intravenous administration. [ 9 ] Hence, we decided to augment systemic colistin with intravitreal colistin. The concentration of intravitreal colistin (0.1 mg/0.1 ml) was the same as was used in the aforementioned studies.…”

Section: Discussionmentioning

confidence: 99%

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Management of multi drug resistant endogenous Klebsiella pneumoniae endophthalmitis with intravitreal and systemic colistin

Dogra

Sharma

Katoch

et al. 2018

Indian J Ophthalmol

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We report a case of a 35-year-old male with a pancreatic pseudocyst, who developed bilateral endogenous endophthalmitis, 4 days after surgical drainage of the pseudocyst. Bacterial cultures of the pancreatic drain fluid and the vitreous tap showed the growth of Klebsiella pneumoniae. The cultured organism was resistant to all the tested antibiotics except colistin. Intravenous colistin was instituted and three injections of intravitreal colistin were given in the left eye of the patient. Complete resolution of infection was seen and visual acuity of 6/6 was regained in both eyes, which was maintained at 4-month follow-up.

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Section: Discussionmentioning

confidence: 99%

“…It exerts its bactericidal effect by damaging bacterial cell membranes and promoting extracellular leakage of cellular proteins leading to cell death. [ 6 9 ]…”

Section: Discussionmentioning

confidence: 99%

Management of multi drug resistant endogenous Klebsiella pneumoniae endophthalmitis with intravitreal and systemic colistin

Dogra

Sharma

Katoch

et al. 2018

Indian J Ophthalmol

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“…Notably, more than 70% of staphylococci isolates exhibited multi-drug resistance. Additionally, S. pneumoniae showed resistance rates of over 38% for azithromycin and penicillin, and P. aeruginosa demonstrated 100% resistance to polymyxin B [ 50 , 51 , 52 ]. However, gram-positive organisms maintained 100% susceptibility to vancomycin in both the ARMOR and EVS reports [ 53 , 54 , 55 ].…”

Section: Antimicrobial Resistance Associated With Endophthalmitismentioning

confidence: 99%

New Approaches to Overcoming Antimicrobial Resistance in Endophthalmitis

Garcia O’Farrill,

Abi Karam,

Villegas

et al. 2024

Pharmaceuticals

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Endophthalmitis is a rare but vision-threatening infection characterized by marked inflammation of intraocular fluids and tissues, uncommonly seen following surgery and intravitreal injection. Antimicrobials are used worldwide in the prophylaxis and treatment of bacterial and fungal infections of the eye and are standard treatment in the preoperative and postoperative care of surgical patients. However, antimicrobials are reported to be overprescribed in many parts of the world, which contributes to antimicrobial resistance (AMR). AMR complicates the prophylaxis and treatment of endophthalmitis. This article examines the prevalence and mechanisms of AMR in ocular microorganisms, emphasizing the importance of understanding AMR patterns for tailored treatments. It also explores prophylaxis and management strategies for endophthalmitis, with a discussion on the use of intracameral antibiotic administration. The use of prophylactic intracameral antibiotics during cataract surgery is common in many parts of the world but is still controversial in some locations, especially in the US. Finally, it highlights the role of stewardship in ophthalmology and its benefits in the treatment of endophthalmitis.

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“…Colistin CSF-to-plasma ratio was 0.05, with absolute concentrations retrieved in CSF allowing to attain optimal PK/PD target only against P. aeruginosa and A. baumannii strains showing an MIC value up to 0.06 mg/L [127]. In regard to ocular penetration, only a preclinical animal model currently assessed this issue in twenty rabbits receiving intravenous colistin at a dosage of 5 mg/kg [128]. Overall, absolute colistin concentrations were extremely low in aqueous humor and undetectable in vitreous humor in most of included cases [128].…”

Section: Pharmacokinetic/pharmacodynamic Featuresmentioning

confidence: 99%

Colistin: Lights and Shadows of an Older Antibiotic

Diani,

Bianco,

Gatti

et al. 2024

Preprint

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The emergence of antimicrobial resistance have represented a serious threats for public health and infections due to multidrug-resistant (MDR) microorganisms represent one of the most important causes of death worldwide. The renew of old antimicrobials, such as colistin, have been proposed as valuable therapeutic alternative to the emergence of the MDR microorganisms. Although colistin is well known to presents several adverse toxic effect, its usage in clinical practice have been reconsidered due to the broad spectrum of activity to gram-negative (GN) bacteria and to the important role of “last resort” agent against MDR-GN. Despite the revolutionary prospective of treatment of this old antimicrobial molecule, many questions remain open regarding the emergence of novel phenotypic traits of resistance and the optimal usage of the colistin in clinical practice. In the last years, several forward steps have been done in the understanding of resistance determinants, clinical usage and pharmacological dosage of this molecule, however, different points regarding the role of colistin in clinical practice and the optimal pharmacokinetic/pharmacodynamic targets are not well defined yet. In this review, we summarize the mode of action, the emerging resistance determinants and its optimal administration in the treatment of difficult-to-treat infections due to MDR Gram-negative bacteria.

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Ocular Penetration of Intravenously Administered Colistin in Rabbit Uveitis Model

Abstract: In our model, colistin did not reach therapeutically relevant levels in the aqueous and in the vitreous humor of rabbit eyes. The findings suggest a limited role for intravenously administered colistin in the treatment of Gram-negative bacterial endophthalmitis.

Cited by 8 publications

References 28 publications

Management of multi drug resistant endogenous Klebsiella pneumoniae endophthalmitis with intravitreal and systemic colistin

Management of multi drug resistant endogenous Klebsiella pneumoniae endophthalmitis with intravitreal and systemic colistin

New Approaches to Overcoming Antimicrobial Resistance in Endophthalmitis

Colistin: Lights and Shadows of an Older Antibiotic

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