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Aqueous and vitreous penetration of levofloxacin after oral administration11The authors have no financial interest in levofloxacin or in any other product mentioned in this article.

1999; Elsevier BV; Volume: 106; Issue: 12 Linguagem: Inglês

10.1016/s0161-6420(99)90527-4

1549-4713

Richard G. Fiscella, Thao K.P Nguyen, Michael Cwik, Brian A Phillpotts, Steven Friedlander, Daniel C Alter, Michael J. Shapiro, Norman P. Blair, Jon P. Gieser,

Antibiotics Pharmacokinetics and Efficacy

Objective To investigate the penetration of levofloxacin, an optical S-(-)isomer of ofloxacin, into the aqueous and vitreous humor after oral administration. Design Randomized, clinical trial comparing tissue levels of levofloxacin after one or two doses 12 hours apart. Participants Forty-five patients undergoing initial vitrectomy between February 1997 and June 1997 at the UIC Eye Center. Methods Aqueous, vitreous, and serum samples were obtained and later analyzed from 45 patients after oral administration of 1 500-mg tablet (group 1, 22 patients) or 2 500-mg tablets (group 2, 23 patients) 12 hours apart before surgery. Main outcome measures Aqueous, vitreous, and serum concentrations of levofloxacin (micrograms/milliliter). Results Group 1 achieved mean aqueous, vitreous, and serum levels of 0.59 ± 0.48 μg/ml, 0.32 ± 0.34 μg/ml, and 4.34 ± 3.59 μg/ml, respectively. Group 2 achieved mean aqueous, vitreous, and serum levels of 1.90 ± 0.97 μg/ml, 2.39 ± 0.70 μg/ml, and 8.02 ± 3.14 μg/ml. Conclusions Mean inhibitory aqueous and vitreous MIC90 levels were achieved against a majority of ocular pathogens, including Staphylococcus aureus and Staphylococcus epidermidis, Streptococcus pneumoniae (vitreous), Bacillus cereus (vitreous), Haemophilus influenzae, Moraxella catarrhalis, and most gram-negative aerobic organisms except Pseudomonas aeruginosa after two doses given 12 hours apart. Mean MIC90 levels were obtained in the vitreous for a majority of pathogens responsible for traumatic, postoperative, or bleb-related endophthalmitis.