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2004
OMIG, Abstract 19
OMIG
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Comparison
of the Penetration into Aqueous Humor in Humans of Two 4th Generation
Fluoroquinolones
JP McCulley, W Shine. University of Texas Southwestern Medical School,
Dallas, Texas
Purpose:
To compare directly the penetration of two commercial 4th
generation fluoroquinolones (FQ) [moxifloxacin and gatifloxacin],
into aqueous humor (AH) in humans after q.i.d. topical application
and to compare to published levels for 2nd and 3rd generation FQs.
Methods: Patients who were otherwise without ocular
disease and scheduled for routine phacoemulsification were given,
in a double masked fashion, either commercial moxifloxacin 0.5%
(Vigamox™) or gatifloxacin 0.3% (Zymar™) to use q.i.d.
the day before surgery and on the day of surgery one hour prior
to the surgical entry into the anterior chamber. AH samples were
taken and chromatographically analyzed by HPLC. AH FQ concentration
was calculated by peak comparison to a known concentration peak
for ciprofloxacin which was run as an internal standard. These were
compared to published concentrations after similar q.i.d. dosing
of other available FQs.
Results: Moxifloxacin concentration was 1.88±0.52ug/ml
and for gatifloxacin 1.06±0.36 ug/ml. Published values after
q.i.d. dosing for ciprofloxacin are 0.07 ug/ml, levofloxacin 0.5%
are 0.28 ug/ml but are unavailable for ofloxacin with q.i.d. dosing.
Conclusion: AH antibiotic concentrations after
loading regiments are of little clinical relevance. Concentrations
achieved at cataract surgery can serve as surrogates for what can
be achieved with post-operative topical dosing, e.g. q.i.d. Both
4th generation FQs achieved adequate concentrations with moxifloxacin
achieving a far superior (clinically significant) concentration
compared to gatifloxacin.
Supported
in part by an unrestricted grant from RPB and Alcon Labs
Disclosure code: F C, R
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