TY - JOUR
T1 - Subconjunctival delivery of antibiotics in a controlled-release system
T2 - A novel anti-infective prophylaxis approach for cataract surgery
AU - Cardillo, José A.
AU - Paganelli, Fernando
AU - Melo, Luiz A.S.
AU - Silva, Arnobio A.
AU - Pizzolitto, Antonio C.
AU - Oliveira, Anselmo G.
AU - Belfort, Rubens
AU - Costa, Rogerio A.
AU - Franzini, Cristina M.
AU - Kuppermann, Baruch D.
AU - Lima-Filho, Acacio A.S.
AU - Lavinsky, Daniel
AU - Höfling-Lima, Ana L.
AU - Nguyen, Quan Dong
AU - Schellini, Silvana A.
AU - Skaf, Mirian
PY - 2010/1
Y1 - 2010/1
N2 - Objective: To compare the efficacy of subconjunctival injection of a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, in a controlledrelease system (DuoCat) with that of ciprofloxacin hydrochloride, 0.3%, eyedrops for infection prophylaxis. Methods: Rabbit eyes were injected subconjunctivally with a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, or ciprofloxacin hydrochloride, 2 mg/0.1 mL, alone. The aqueous and vitreous humor pharmacokinetic profiles were compared with those of a single drop of ciprofloxacin hydrochloride, 0.3%, 6 times daily. In 45 rabbits, Staphylococcus aureus was injected into the anterior chamber: 15 randomly received 1 drop of ciprofloxacin hydrochloride, 0.3%, every 4 hours during 24 hours; 15 received drops of balanced salt solution; and 15 received a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL. After 24 hours, endophthalmitis scores were recorded, aqueous and vitreous humors underwent culture, and histologic analysis was performed. Results: The combined triamcinolone and ciprofloxacin treatment allowed higher intraocular levels of ciprofloxacin. The median endophthalmitis clinical scores for the combination of triamcinolone and ciprofloxacin and ciprofloxacin-only eyedrop groups were equivalent (P=.42) and were significantly lower than those of the balanced salt solution group (P<.001). The culture was negative for S aureus in the combined triamcinolone and ciprofloxacin and ciprofloxacin eyedrop regimens. No adverse effects were observed with either route. Conclusions: Ciprofloxacin eyedrops and combined triamcinolone and ciprofloxacin were equally tolerated and efficacious. The combined triamcinolone and ciprofloxacin treatment may eliminate noncompliance issues and may prove to be a valuable clinical tool for surgical prophylaxis. Clinical Relevance: The combined triamcinolone and ciprofloxacin treatment may be a new useful strategy for surgical prophylaxis.
AB - Objective: To compare the efficacy of subconjunctival injection of a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, in a controlledrelease system (DuoCat) with that of ciprofloxacin hydrochloride, 0.3%, eyedrops for infection prophylaxis. Methods: Rabbit eyes were injected subconjunctivally with a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, or ciprofloxacin hydrochloride, 2 mg/0.1 mL, alone. The aqueous and vitreous humor pharmacokinetic profiles were compared with those of a single drop of ciprofloxacin hydrochloride, 0.3%, 6 times daily. In 45 rabbits, Staphylococcus aureus was injected into the anterior chamber: 15 randomly received 1 drop of ciprofloxacin hydrochloride, 0.3%, every 4 hours during 24 hours; 15 received drops of balanced salt solution; and 15 received a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL. After 24 hours, endophthalmitis scores were recorded, aqueous and vitreous humors underwent culture, and histologic analysis was performed. Results: The combined triamcinolone and ciprofloxacin treatment allowed higher intraocular levels of ciprofloxacin. The median endophthalmitis clinical scores for the combination of triamcinolone and ciprofloxacin and ciprofloxacin-only eyedrop groups were equivalent (P=.42) and were significantly lower than those of the balanced salt solution group (P<.001). The culture was negative for S aureus in the combined triamcinolone and ciprofloxacin and ciprofloxacin eyedrop regimens. No adverse effects were observed with either route. Conclusions: Ciprofloxacin eyedrops and combined triamcinolone and ciprofloxacin were equally tolerated and efficacious. The combined triamcinolone and ciprofloxacin treatment may eliminate noncompliance issues and may prove to be a valuable clinical tool for surgical prophylaxis. Clinical Relevance: The combined triamcinolone and ciprofloxacin treatment may be a new useful strategy for surgical prophylaxis.
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U2 - 10.1001/archophthalmol.2009.352
DO - 10.1001/archophthalmol.2009.352
M3 - Article
C2 - 20065222
AN - SCOPUS:75349093748
SN - 0003-9950
VL - 128
SP - 81
EP - 87
JO - Archives of ophthalmology
JF - Archives of ophthalmology
IS - 1
ER -