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2004
OMIG, Abstract 17
OMIG
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Intravitreal
VigamoxTM (0.5% Moxifloxacin) is Non-Toxic and Effective
in Preventing Endophthalmitis in a NZW Rabbit Model
RP Kowalski, EG Romanowski, FS Mah, KA Yates, YJ Gordon. The Charles
T. Campbell Laboratory, University of Pittsburgh, Pittsburgh, PA
Purpose:
To determine whether Vigamox™ (0.5% moxifloxacin, Alcon Laboratories,
Ft. Worth, TX) can be safely injected intravitreally to prevent
Staphylococcus aureus endophthalmitis.
Methods: The safety and bactericidal effectiveness
of Vigamox™ was evaluated in three experiments using 186 NZW
rabbits. 1) A reproducible rabbit model of Staphylococcus aureus
endophthalmitis was established. 2) The toxicity of four intravitreal
doses of Vigamox™ (moxifloxacin 500, 250, 125, 50 ug) was
compared to vancomycin (1 mg) and saline. 3) The bactericidal effect
of Vigamox™ (moxifloxacin 500, 250, 125, 50 ug) was compared
to vancomycin (1 mg) and saline using a one-eye design. The Staphylococcus
aureus intravitreal inoculum necessary to reproduce endophthalmitis
was 5 x 103 CFU. Intravitreal therapy commenced immediately after
bacterial intravitreal challenge. The safety was evaluated with
clinical examination using a slit lamp and an indirect opthalmoscope.
The clinical examination included the exterior eye, cornea, anterior
chamber, vitreous, and retina. The presentations were graded on
a severity scale of 0, 0.5, 1, 2, and 3. The bactericidal effectiveness
was determined using colony counts of the vitreous 24 hours after
intravitreal therapy. All data were analyzed parametrically using
ANOVA with significance set at p=0.05.
Results: The total clinical scores of rabbits injected
intravitreally with Vigamox™, at all doses, were statistically
equivalent to rabbits given intravitreal vancomycin or saline. The
vitreous of all eyes treated with Vigamox™, at all doses,
and vancomycin were negative for Staphylococcus aureus,
and the colony counts were 6 logs lower than the non-treated (control)
group and 3 logs lower than the initial inoculum.
Conclusion: Vigamox™ appears to be safe for
injection into the vitreous to prevent experimental endophthalmitis.
Further clinical studies will determine the role of intravitreal
Vigamox™ for surgical prophylaxis and post-operative therapy.
Disclosure code: FCR
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