Aras Cengiz, Ozdamar Akif, Ozturk Recep, Karacorlu Murat, Ozkan Sehirbay
Department of Ophthalmology, Cerrahpasa Medical School, Istanbul, Turkey.
Ophthalmologica. 2002 Jul-Aug;216(4):261-4. doi: 10.1159/000063838.
To investigate the penetration of cefepime (a fourth-generation cephalosporin) into the vitreous after single-dose intravenous administration to human subjects.
Thirty phakic patients about to undergo vitreous surgery received 1 g (group 1, 15 patients) or 2 g cefepime (group 2, 15 patients) in a single intravenous injection before surgery. The indications for vitreous surgery were retinal detachment with proliferative vitreoretinopathy (24 patients), retinal detachment associated with giant retinal tear (4 patients), macular hole (1 patient) and intraocular foreign body (1 patient). Samples of vitreous and serum were obtained at 0.5, 1, 2, 4 and 12 h after injection. Three patients were used for each sampling time and for 1 g and 2 g of cefepime. Samples were assayed for cefepime concentrations with high-performance liquid chromatography (HPLC).
All the patients had detectable cefepime in their vitreous and serum measurable by HPLC. The level of cefepime in the vitreous peaked at 2 h and reached a minimum at 12 h after intravenous injection in both groups. A mean peak vitreous level of cefepime was 1.91 +/- 0.13 microg/ml in group 1 and 2.86 +/- 0.37 microg/ml in group 2. The level of cefepime in the vitreous at 12 h after injection was 0.89 +/- 0.14 microg/ml in group 1 and 0.97 +/- 0.30 microg/ml in group 2.
The vitreous level of cefepime after intravenous injection was below the minimum inhibitory concentration (MIC(90)) against Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa, but was over the MIC(90) against Proteus mirabilis, Klebsiella spp., Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and Enterobacter spp.
研究单剂量静脉注射头孢吡肟（一种第四代头孢菌素）后在人体受试者玻璃体中的渗透情况。
30例即将接受玻璃体手术的有晶状体眼患者在手术前接受单次静脉注射1g头孢吡肟（第1组，15例患者）或2g头孢吡肟（第2组，15例患者）。玻璃体手术的适应证为伴有增殖性玻璃体视网膜病变的视网膜脱离（24例患者）、与巨大视网膜裂孔相关的视网膜脱离（4例患者）、黄斑裂孔（1例患者）和眼内异物（1例患者）。在注射后0.5、1、2、4和12小时采集玻璃体和血清样本。每个采样时间以及1g和2g头孢吡肟剂量均使用3例患者。采用高效液相色谱法（HPLC）测定样本中的头孢吡肟浓度。
所有患者的玻璃体和血清中均可通过HPLC检测到头孢吡肟。两组患者静脉注射后玻璃体中头孢吡肟水平在2小时达到峰值，12小时降至最低。第1组头孢吡肟玻璃体平均峰值水平为1.91±0.13μg/ml，第2组为2.86±0.37μg/ml。注射后12小时第1组玻璃体中头孢吡肟水平为0.89±0.14μg/ml，第2组为0.97±0.30μg/ml。
静脉注射后头孢吡肟在玻璃体中的水平低于对金黄色葡萄球菌、表皮葡萄球菌和铜绿假单胞菌的最低抑菌浓度（MIC90），但高于对奇异变形杆菌、克雷伯菌属、流感嗜血杆菌、肺炎链球菌、化脓性链球菌和肠杆菌属的MIC90。
