Penetration of ocular compartments by tetracyclines

Salminen, Leena

doi:10.1007/bf00414847

Cited by 14 publications

(3 citation statements)

References 16 publications

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“…32 In rabbits, doxycycline has better penetration into ocular tissues than tetracycline. 33 The authors of that study speculated that this was attributable to the increased lipophilicity of doxycycline, compared with tetracycline, which allowed for easier movement of the drug across the blood-ocular barrier. Doxycycline has been used in equine medicine for anterior uveitis in horses with suspected infections with Leptospira spp.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses

Davis¹,

Salmon²,

Papich³

2006

American Journal of Veterinary Research

125

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Results suggest that doxycycline administered at a dosage of 20 mg/kg, PO, every 24 hours will result in drug concentrations adequate for killing intracellular bacteria and bacteria with minimum inhibitory concentration < or = 0.25 microg/mL. For bacteria with minimum inhibitory concentration of 0.5 to 1.0 microg/mL, a dosage of 20 mg/kg, PO, every 12 hours may be required; extreme caution should be exercised with the higher dosage until more safety data are available.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses

Davis¹,

Salmon²,

Papich³

2006

American Journal of Veterinary Research

125

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“…With no references, the French guidelines for Lyme disease state that doxycycline should not be given in intraocular disease due to poor intraocular penetration [1]. Two studies of systemic doxycycline in horses [31,32] and one study of systemic doxycycline in rabbits [33] showed poor intraocular concentrations of doxycycline. In our material, we had three cases that used oral doxycycline (Linna et al [12], Preac-Mursic et al [7], and our case).…”

Section: Evaluation Of Treatment Strategiesmentioning

confidence: 99%

Borrelia Ocular Infection: A Case Report and a Systematic Review of Published Cases

Lindström¹,

Skogman²,

Lindström³

et al. 2022

Ophthalmic Res

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Introduction: Lyme borreliosis can cause many diverse manifestations, also ocular disease where the diagnosis of ocular borreliosis is challenging. The primary aim was to report on the evidence of Borrelia spirochetes in the ocular tissue in presumed ocular borreliosis. Methods: A systematic review of pathological eye conditions was performed where Borrelia has been suspected in relevant ocular tissue, together with a case report of diagnosed uveitis with polymerase chain reaction (PCR)-confirmed Borrelia afzelii in the vitreous. The evidence for clinical and laboratory diagnosis was evaluated systematically. As a secondary aim, the treatment of ocular Borrelia infection was also evaluated for confirmed cases. Results: Thirteen includable studies were found, and after the removal of case duplicates, eleven unique cases were extracted. Apart from the present case report, 4 other cases reported strong evidence for the detection of B. spirochetes in ocular tissue. Four cases presented reasonable evidence for assumed detected Borrelia, while three additional cases showed only weak diagnostic credibility that Borrelia was detected. Conclusion: This systematic review, including all reported cases and our case report, supports evidence of ocular infection of Borrelia species. Furthermore, in case of suspicion of infection and seronegativity, it is justified to look for Borrelia in eye tissue samples. In addition, microscopy without using PCR is not sufficient to confirm the diagnosis of borreliosis on ocular tissue. In the articles studied, there was no unambiguous recommendation of treatment.

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“…23 This would decrease the anti-inflammatory effects of prednisone and the antimicrobial and anti-inflammatory effects of doxycycline. Doxycycline has been shown to penetrate ocular tissues well, 24 is antiangiogenic, and can decrease orbital inflammation. 25,26 Combined steroid and antibiotic therapy has been associated with good visual outcome in patients with severe vision loss from cat scratch disease, and this was true in this case.…”

Section: Treatment and Outcomementioning

confidence: 99%

Case Report: Treatment of Severe Neuroretinitis and other Sequelae Associated with Cat Scratch Disease

Whorff¹

2022

Optom Vis Sci

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SIGNIFICANCE:Severe vision loss from Bartonella neuroretinitis can be best treated to improve visual outcomes with a combination of systemic corticosteroids and antibiotics. Topical ketorolac 0.5% and difluprednate 0.05% are presented as a new adjunct therapy to potentially improve visual outcomes. PURPOSE: This case illustrates severe posterior pole complications that can occur with cat scratch disease disseminated to the eye. Combination therapy with antibiotics and corticosteroids results in better visual outcomes. Topical treatment might further enhance visual outcome by preventing inflammatory damage without significant immunosuppression.CASE REPORT: A 17-year-old male teenager presented with right eye vision loss. He had been hospitalized 2 weeks prior for optic neuritis and treated with intravenous methylprednisolone. After 3 days, vision had improved from 20/200 to 20/40. After positive serology for Bartonella henselae was obtained, he was released and treated with oral rifampin, doxycycline, and prednisone. Sixteen days later, he regressed to 20/200, and many more ophthalmic complications were observed. After discontinuation of rifampin, oral prednisone was continued for an additional 2 weeks, and doxycycline was continued for approximately 3 weeks. Topical drops ketorolac 0.5% twice a day and difluprednate 0.05% four times a day were used for more than 6 weeks before tapering after vision returned to normal.CONCLUSIONS: Bartonella neuroretinitis associated with pre-retinal hemorrhage, vitritis, and subretinal hemorrhage can be successfully treated with a combination of systemic medications and topical drops. Monotherapy with doxycycline is effective and well tolerated. Rifampin can cause rapid metabolization and reduction in plasma levels of both prednisone and doxycycline and should be avoided with combined therapy. Oral prednisone and topical difluprednate are recommended to quell initial inflammation during the first few weeks. The anti-inflammatory effects of doxycycline and topical ketorolac used for longer duration may be beneficial in preventing tissue damage without systemic immunosuppression and result in better visual outcomes.

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Penetration of ocular compartments by tetracyclines

Cited by 14 publications

References 16 publications

Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses

Pharmacokinetics and tissue distribution of doxycycline after oral administration of single and multiple doses in horses

<b><i>Borrelia</i></b> Ocular Infection: A Case Report and a Systematic Review of Published Cases

Case Report: Treatment of Severe Neuroretinitis and other Sequelae Associated with Cat Scratch Disease

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