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Oral levofloxacin adequate for preventing ocular infections in study
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Oral levofloxacin administered at doses of 400 mg/day provides adequate ocular penetration for preventing infections in the anterior chamber and vitreous of vitrectomy patients, according to a recent study.
H. Sakamoto and colleagues at Kyushu University Graduate School of Medicine in Fukuoka, Japan, measured anterior chamber and vitreous humor concentrations of the drug in 36 patients undergoing vitrectomy with phacoemulsification and aspiration.
Patients were randomly divided into three groups. The first group received topical levofloxacin three times 1 day before surgery and seven times on the day of surgery. The second group received 200 mg of levofloxacin orally twice 1 day before surgery and another 200 mg 3 hours preop. Patients in the third group received both topical and oral drug regimens, according to the study.
The researchers found that levofloxacin concentrations in the aqueous humor averaged 0.765 ± 0.624 µg/mL in the first group, 1.279 ± 0.440 µg/mL in the second group and 1.823 ± 0.49 µg/mL in the third group.
Drug concentrations in the vitreous fluid averaged less than 0.02 µg/mL in the first group, 1.455 ± 0.445 µg/mL in the second group and 1.369 ± 0.53 µg/mL in the third group, according to the study.
"Oral administration of levofloxacin at a dose of 400 mg/day was sufficient for the prophylaxis of ocular infections because the drug concentrations in both aqueous humor and vitreous fluid were higher than the MIC90 values for major ocular pathogens," the study authors said.
"Topical application of levofloxacin achieved adequate drug levels in aqueous humor, but not in vitreous fluid, while combined topical and oral administration had an additive effect on the drug concentration in aqueous humor," they said.
The study is published in May/June issue of European Journal of Ophthalmology.