Rétinopathie toxique sur injection intravitréenne d'Amikacine et Vancomycine

Piguet, B; Chobaz, Christine; Grounauer, P. A.

doi:10.1055/s-2008-1035237

Cited by 10 publications

(3 citation statements)

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“…The antimicrobial effect of glycopeptide antibiotics such as vancomycin depends on the length of time its concentration is maintained above the MIC 1112 Thus, dosing strategies should optimise the duration of drug exposure to concentrations above the MIC, rather than to aim at higher peak levels 910 In this respect, adequate and safe antibiotic levels can be better achieved by more frequent rather than higher dosages.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal vancomycin and gentamicin concentrations in patients with postoperative endophthalmitis

Gan

Dissel²,

Beekhuis³

et al. 2001

British Journal of Ophthalmology

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Background/aims-To study the intravitreal antibiotic concentrations and the eYcacy of an intravitreal dosing regimen to treat patients with postoperative bacterial endophthalmitis. This regimen, based on pharmacokinetic/pharmacodynamic considerations, relies on a repeat antibiotic injection of a lower dose than is generally used. Methods-In consecutive patients with suspected postoperative endophthalmitis a vitreous biopsy for bacterial culture was taken before 0.2 mg vancomycin and 0.05 mg gentamicin were injected intravitreally. After 3 or 4 days a second biopsy was taken for bacteriological culture and to measure intravitreal vancomycin and gentamicin concentrations, followed by a repeat injection of 0.2 mg vancomycin. Results-17 patients entered the study. In 11 patients the initial bacterial culture was positive, predominantly coagulase negative staphylococci. All second vitreous biopsies were sterile. Intravitreal vancomycin levels varied between 2.6 and 18.0 µg/ml (mean 10.3 (SD 4.1) µg/ml) after 3 days and between 3.1 and 16.6 µg/ml (mean 7.5 (6.2) µg/ml) after 4 days which is well above the minimal inhibitory concentration for most micro-organisms. Concentrations of intravitreal gentamicin varied between 0.90 and 3.3 µg/ml (mean 1.6 (0.72) µg/ml) after 3 days and between 1.2 and 2.6 µg/ml (mean 1.9 (0.99) µg/ml) after 4 days. Conclusion-This dosing regimen resulted both in adequate intravitreal vancomycin and gentamicin levels for over a week as well as in negative second cultures. This study also provides new information on intravitreal vancomycin and gentamicin concentration over time in patients with postoperative endophthalmitis. (Br J Ophthalmol 2001;85:1289-1293 Bacterial endophthalmitis is a severe complication of intraocular surgery that may rapidly cause permanent visual loss. Therefore, when confronted with a possible postoperative infection of the eye, timely diagnostic and empirical therapeutic decisions should be made by medical history taking and a focused examination without the aid of the results of laboratory and culture results. If it is likely that the symptoms and signs are due to bacterial infection, prompt antimicrobial treatment is indicated.In empirical therapy, the activity spectrum of the antibiotic should cover all likely causative micro-organisms. Other important parameters directing the choice and dosing regimen of antibiotics in endophthalmitis include the ability to achieve eVective concentrations of the drug inside the eye, especially the vitreous, and the toxicity of the drug for retinal structures. The vast majority of postoperative eye infections are caused by Gram positive bacteria such as coagulase negative staphylococci, S aureus, and streptococci.1-3 Awaiting culture results and susceptibility testing, the methicillin resistance of many strains of staphylococci make glycopeptides such as vancomycin the antibiotic of choice. 1 3-6 As the penetration of this drug into non-vitrectomised, inflamed eyes after intravenous administration is unreliable, direct intr...

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Section: Discussionmentioning

confidence: 99%

Intravitreal vancomycin and gentamicin concentrations in patients with postoperative endophthalmitis

Gan

Dissel²,

Beekhuis³

et al. 2001

British Journal of Ophthalmology

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“…54 As Piguet himself puts it, 'climate change is global and borderless, but climate science is not!' 55 Not only does this create 'a Promethean illusion of immunity' around the Global North as a source of climate migration, but it serves also to reinforce and energise a research agenda focused on Global Southern vulnerabilities and international flows. 56 If Northern funders are to be convinced of the relevance of work on the Global South, then securitisation-the idea that Global Southern climate migrants pose a tangible threat to Global Northern nations-is a powerful line of argument.…”

Section: Laurie Parsonsmentioning

confidence: 99%

Climate migration and the UK

Parsons¹

2021

JBA

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This article discusses the relationship between climate change and migration in the context of the UK. After a brief overview of climate migration scholarship, it examines the framing of climate migration as a crisis in UK policy discourse, highlighting the disjuncture between policy and academic scholarship in this respect. Subsequently, it examines the reasons for this schism, exploring both the framing of climate migration within the UK media landscape and the securitisation of the topic within UK government policy. Finally, the article explores how the UK�s political landscape undergirds the political logic of climate finance, emphasising the role of British domestic politics in shaping the boundaries and direction of climate change as it manifests in governance. The article closes by exploring potential new directions in UK climate migration policy.

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“…Это означает, что удержание оптимальной терапевтической концентрации может достигаться не за счёт увеличения дозы, а за счёт увеличения кратности инъекций. Тем более что увеличение дозы может привести к повышен-ному риску ретинотоксичности [31]. В настоящее время предложены для лечения ванкомицин-резистентных интраокулярных инфекций новые антибиотики, кото-рые обладают высоким профилем безопасности.…”

Section: Introductionunclassified

Modern Aspects of the Treatment of Acute Bacterial Postoperative Endophthalmitis

Казайкин¹,

Ponomarev²,

Тахчиди³

2017

test

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Rétinopathie toxique sur injection intravitréenne d'Amikacine et Vancomycine

Abstract: This case demonstrates that a single intravitreal injection of Amikacin and Vancomycin at usual concentration may induce retinal toxicity with permanent damage.

Cited by 10 publications

References 0 publications

Intravitreal vancomycin and gentamicin concentrations in patients with postoperative endophthalmitis

Intravitreal vancomycin and gentamicin concentrations in patients with postoperative endophthalmitis

Climate migration and the UK

Modern Aspects of the Treatment of Acute Bacterial Postoperative Endophthalmitis

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