Title: Bactericidal effect of intravitreal levofloxacin in an experimental model of endophthalmitis
Abstract: <h3>Aim:</h3> To evaluate the efficacy of intravitreal 1.5% levofloxacin versus combined treatment with vancomycin and ceftazidime in an experimental model of bacterial endophthalmitis. <h3>Methods:</h3> The right eye of 75 New Zealand White rabbits was inoculated in the vitreous cavity with strains of <i>Staphylococcus epidermidis</i>, <i>Staphylococcus aureus</i> or <i>Pseudomonas aeruginosa</i>. The study evaluated treatment with 1.5% levofloxacin compared with 1% vancomycin plus 2.2% ceftazidime, and a control group. At 24 h after treatment, 100 μl vitreous and aqueous humor were harvested, and the number of colony-forming units (CFU) per ml was determined. The microbiological status of the vitreous and aqueous humor samples was tested at day 2, 3, 5 and 8. The Peyman classification was used to assess the severity of endophthalmitis. <h3>Results:</h3> For the <i>S epidermidis</i> endophthalmitis model, levofloxacin treatment produced an approximately 3 log decrease in CFU/ml of vitreous relative to that in untreated eyes (p = 0.023), whereas vancomycin plus ceftazidime produced a 5 log reduction in CFU/ml (p = 0.023). However, in the <i>S aureus</i> model, levofloxacin treatment produced an approximately 4 log reduction in CFU/ml, whereas vancomycin plus ceftazidime produced an approximately 2 log reduction in CFU/ml relative to that of the control (p = 0.018 and p = 0.019, respectively). Treatment of <i>P aeruginosa</i>-infected rabbit eyes with levofloxacin produced a 5 log reduction in CFU/ml of vitreous, whereas vancomycin plus ceftazidime produced an approximately 3–4 log reduction in CFU/ml relative to that of the control (p = 0.001). However, there was no significant difference between levofloxacin and vancomycin plus ceftazidime on comparing the reduction of CFU/ml of vitreous for any of the bacterial strains studied. <h3>Conclusions:</h3> Levofloxacin appears to be effective in treating experimental endophthalmitis in the rabbit model. Further studies, especially on the toxicity of intravitreal levofloxacin, are required before a clinical role for the drug in postoperative therapy can be determined.
Publication Year: 2008
Publication Date: 2008-01-22
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 11
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