Subconjunctival Delivery of Antibiotics in a Controlled-Release System A Novel Anti-infective Prophylaxis Approach for Cataract Surgery
Cardillo, Jose A. [UNIFESP]
Paganelli, Fernando [UNIFESP]
Melo, Luiz A. S. [UNIFESP]
Silva, Arnobio A.
Pizzolitto, Antonio C.
Oliveira, Anselmo G.
Brazilian Ocular Pharmacology Phar
Is part ofArchives of Ophthalmology
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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.
CitationArchives of Ophthalmology. Chicago: Amer Medical Assoc, v. 128, n. 1, p. 81-87, 2010.
SponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Conselho Nacional de Pesquisa
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