Journal Article

Ocular penetration of levofloxacin, ofloxacin and ciprofloxacin in eyes with functioning filtering blebs: investigator masked, randomised clinical trial

Yung, C W, Cantor, L B, Morgan, L S, Valluri, S, WuDunn, D, Catoira, Y P, Hoop, J S

2008

Overview

Background/aims: To compare the penetration of levofloxacin, ofloxacin and ciprofloxacin in the aqueous humour of eyes with functioning filtering blebs.Methods: In this investigator-masked study, 48 patients with functioning filtering blebs requiring cataract surgery were randomised into six groups of eight patients. Groups 1, 2 and 3 received topical ofloxacin 0.3% (Ocuflox®), ciprofloxacin 0.3% (Ciloxan®) and levofloxacin (Quixin®) respectively; Groups 4, 5 and 6 received the same treatment with the corresponding oral dose of ofloxacin 400 mg (Floxin), ciprofloxacin 400 mg (Cipro) and levofloxacin 250 mg (Levaquin). Aqueous antibiotic levels were determined by mass spectrometry of aqueous samples from each patient.Results: The mean aqueous level for topical levofloxacin was significantly higher than those achieved by topical ofloxacin or ciprofloxacin (p value = 0.02 and 0.01, respectively). The combination of topical and oral levofloxacin was significantly higher than topical levofloxacin alone (p = 0.05) and the ciprofloxacin combination (p = 0.003) but not significantly higher than the ofloxacin combination therapy.Conclusions: Topical levofloxacin penetrates better than ofloxacin or ciprofloxacin into the aqueous of eyes with functioning filtering blebs. The combination of topical and oral levofloxacin may be preferable in the treatment of bleb-associated infections (NCT 00392275; Clinical trials.gov).

• Publisher: BMJ Publishing Group Ltd,BMJ,BMJ Publishing Group LTD
• Subject: Administration, Oral / Anti-Bacterial Agents - administration & dosage / Anti-Bacterial Agents - pharmacokinetics / Antibiotics / Aqueous Humor - metabolism / Biological and medical sciences / Cataract Extraction / Cataracts / Ciprofloxacin - administration & dosage / Ciprofloxacin - pharmacokinetics / Drug Therapy, Combination / Eye Infections, Bacterial - drug therapy / Eye Infections, Bacterial - metabolism / Eye surgery / Filtering Surgery / Humans / Infections / Levofloxacin / Medical sciences / Miscellaneous / Ofloxacin - administration & dosage / Ofloxacin - pharmacokinetics / Ophthalmic Solutions / Ophthalmology / Prospective Studies / Sample size / Single-Blind Method / Standard deviation / Surgery / Surgical Wound Infection - drug therapy / Surgical Wound Infection - metabolism