Subconjunctival Delivery of Antibiotics in a Controlled-Release System A Novel Anti-infective Prophylaxis Approach for Cataract Surgery

Author(s)

Cardillo, Jose A. ^{[1, 2, 3]} ; Paganelli, Fernando ^{[1, 2, 3]} ; Melo, Jr., Luiz A. S. ^[1] ; Silva, Jr., Arnobio A. ^[4] ; Pizzolitto, Antonio C. ^[4] ; Oliveira, Anselmo G. ^[4] ; Phar, Brazilian Ocular Pharmacology

Affiliation

^[1] Univ Fed Sao Paulo, EPM, Dept Ophthalmol, Sao Paulo - Brazil

^[2] Hosp Olhos Araraquara, Sao Paulo - Brazil

^[3] UNIARA, Sao Paulo - Brazil

^[4] Univ Estadual Paulista, Sch Pharmaceut Sci, BR-14801902 Sao Paulo - Brazil

• Document type: Journal article
• Source: ARCHIVES OF OPHTHALMOLOGY; v. 128, n. 1, p. 81-87, JAN 2010.
• Web of Science Citations: 16

Abstract

Objective: To compare the efficacy of subconjunctival injection of a combination of triamcinolone and ciprofloxacin hydrochloride, 2 mg/0.1 mL, in a controlled-release 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, 2mg/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. (AU)

• FAPESP's process: 98/10066-7 - Chemical and biological reactivity in interfaces
• Grantee: Hernan Chaimovich Guralnik
• Support Opportunities: Research Projects - Thematic Grants