Aqueous humor concentrations of topical fluoroquinolones alone or in combination with a steroid

Aqueous humor concentrations of topical fluoroquinolones alone or in combination with a steroid

Alternative title Concentração de fluorquinolonas no humor aquoso após instilação tópica das associações com corticosteroides
Author Rodrigues Gomes, Rachel Lopes Autor UNIFESP Google Scholar
Viana, Rodrigo Galvao Google Scholar
Soares Melo, Luiz Alberto, Jr. Autor UNIFESP Google Scholar
Cruz, Alessandro Carvalho Autor UNIFESP Google Scholar
de Souza Lima Filho, Acacio Alves Autor UNIFESP Google Scholar
Suenaga, Eunice Mayumi Autor UNIFESP Google Scholar
Campos, Mauro Autor UNIFESP Google Scholar
Abstract Purpose: To compare the aqueous humor (AH) concentrations of moxifloxacin 0.5% and gatifloxacin 0.3% solutions alone or when treatment was combined with steroids, and to correlate these concentrations with the minimum inhibitory concentrations (MIC) for the most common endophthalmitis-causing organisms. Methods: Patients undergoing phacoemulsification were enrolled to receive one drop of one of the following solutions: moxifloxacin (G1), moxifloxacin + dexamethasone (G2), gatifloxacin (G3), or gatifloxacin + c (G4), every 15 min, 1h before surgery. AH samples were collected before surgery and analyzed using HPLC-tandem mass spectrometry. Results: The mean antibiotic concentrations in the AH were: G1= 1280.8 ng/mL, G2= 1644.3 ng/mL, G3= 433.7 ng/mL and G4= 308.1 ng/mL. The mean concentrations statistically differed between G1 and G2 (p=0.01), and G3 and G4 (p=0.008). All samples achieved the MIC for Staphylococcus epidermidis 100% of the samples from G1 and G2, and 97% from G3 and G4 reached the MIC for fluoroquinolone-sensitive Staphylococcus aureus 100% of the samples from G1 and G2, 88% from G3, and 72% from G4 reached the MIC for enterococci (p<0.001) and 100% of samples from G1 and G2, 59% from G3, and 36% from G4 reached the MIC for Streptococcus pneumoniae (p<0.001). For fluoroquinolone-resistant S. aureus, 23% from G1, 44% from G2, and no samples from G3 or G4 achieved the MIC (p<0.001). Conclusions: Moxifloxacin + dexamethasone demonstrated a higher concentration in the AH than the moxifloxacin alone. Gatifloxacin + steroids demonstrated less penetration into the anterior chamber than gatifloxacin alone. Moxifloxacin was superior to gatifloxacin considering the MIC for enterococci, S. pneumoniae, and fluoroquinolone-resistant S. aureus.

Objetivos: Comparar a concentração no humor aquoso entre as soluções de moxifloxacina 0,5% e gatifloxacina 0,3% sozinhas ou combinadas com corticosteroides, e correlacionar a concentração com a concentração inibitória mínima (MIC) para os agentes microbianos mais comumente relacionados a endoftalmites. Métodos: Pacientes que seriam submetidos a cirurgia de catarata foram selecionados para receber 1 gota a cada 15 min, 1 hora antes do procedimento de uma das seguintes soluções: moxifloxacina (G1), moxifloxacina + dexametasona (G2), gatifloxacina (G3) ou gatifloxacina + prednisolona (G4). Amostras do humor aquoso foram coletadas antes do início da cirurgia. Espectrofotometria de massa por HPLC determinou a concentração do antibiótico nas amostras. Resultados: A concentração media de antibiótico nas amostras foram: G1= 1280,8 ng/mL; G2= 1644,3 ng/mL; G3= 433,7 ng/mL; G4= 308,1 ng/mL. Concentração média entre G1 e 2 (p=0,01), e G3 e 4 (p=0,008). Todas as amostras alcançaram MIC para S. epidermidis; 100% das amostras do G1 e 2, e 97% do G3 e 4 atingiram o MIC para S. aureus fluoroquinolona-sensível; 100% das amostras do G1 e 2, 88% do G3 e 72% do G4 atingiram o MIC para Enterococci (p<0,001); e 100% das amostras do G1 e 2, 59% do G3 e 36% do G4 atingiram o MIC para S. pneumoniae (p<0,001). Para o S. aureus resistente a fluoroquinolona, 23% do G1, 44% do G2, e nenhuma das amostras G3 e 4 atingiram o MIC (p<0,001). Conclusão: Moxifloxacina + dexamethasona demonstrou maior concentração no humor aquoso comparado com a moxifloxacina sozinha. Gatifloxacina + esteróide demonstrou menor penetração na câmara anterior comparado a solução de ga­ti­floxacin sem corticóide. A moxifloxacina foi superior a gatifloxacina considerando o MIC para Enterococci, S. pneumoniae e S. aureus fluorquinolona resistente.
Keywords Aqueous humor
Ophthalmic solutions
Antibiotic prophylaxis
Fluoroquinolones
Steroids
Adrenal cortex hormones
Anti-bacterial agents
Comparative study
Humor aquoso
Soluções oftálmicas
Antibioticoprofilaxia
Fluoroquinolonas; Esteroides
Corticosteroides
Antibacterianos
Estudo comparativo
Language English
Date 2017
Published in Arquivos Brasileiros De Oftalmologia. Sao Paulo, v. 80, n. 5, p. 300-303, 2017.
ISSN 0004-2749 (Sherpa/Romeo, impact factor)
Publisher Consel Brasil Oftalmologia
Extent 300-303
Origin http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492017000500007
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000415347000007
SciELO ID S0004-27492017000500007 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/51250

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