Mizuki Nobuhisa, Watanabe Yoichiro, Miyamoto Mariko, Iijima Yasuhito, Takiyama Naoaki, Ito Yoshiki, Ito Norihiko, Nishida Tomomi, Iwata Shinko, Endo Yoko, Ito Daizo
Department of Ophthalmology, Yokohama City University School of Medicine, Kanagawa, Japan.
Ocul Immunol Inflamm. 2005 Apr-Jun;13(2-3):229-34. doi: 10.1080/09273940590928607.
We intravenously administered flomoxef sodium (FMOX) 120 minutes before cataract surgery, topically administered levofloxacin (LVFX) into the eyes four times at 30-minute intervals before surgery, and measured the aqueous humor concentrations of these agents to investigate their penetration into the aqueous humor and their efficacy in the prevention of postoperative endophthalmitis.
Sixty-eight patients who underwent cataract surgery at the Department of Ophthalmology, Yokohama City University School of Medicine, or its affiliate, Kanazawa Hospital, Yokohama, were enrolled in this study. They received one or both of the following: 1.0 g FMOX via a 20-minute intravenous drip and LVFX ophthalmic solution applied four times at 30-minute intervals, both beginning two hours before the operation. Aqueous humor was aspirated from the anterior chamber and assayed for FMOX and LVFX concentrations using high-performance liquid chromatography (HPLC).
The mean intraoperative FMOX and LVFX concentrations in the patients' aqueous humor were 1.21 +/- 0.63 microg/ml and 0.69 +/- 0.47 microg/ml, respectively. These concentrations sufficiently exceeded the MIC90 values against Staphylococcus epidermidis, S. aureus, and Propionibacterium acnes.
The FMOX and LVFX concentrations in the aqueous humor sampling were adequate to kill bacteria in vitro. These drugs may have efficacy in the prevention of postoperative endophthalmitis in patients undergoing cataract surgery.
我们在白内障手术前120分钟静脉注射氟莫西钠（FMOX），并在手术前每隔30分钟向眼内局部应用左氧氟沙星（LVFX）4次，然后测量这些药物在房水中的浓度，以研究它们在房水中的渗透情况及其预防术后眼内炎的效果。
本研究纳入了在横滨市立大学医学院眼科或其附属的横滨金泽医院接受白内障手术的68例患者。他们接受以下一种或两种治疗：在手术前两小时开始，通过20分钟静脉滴注给予1.0 g FMOX，并每隔30分钟局部应用LVFX眼药水4次。从前房抽取房水，使用高效液相色谱法（HPLC）测定FMOX和LVFX的浓度。
患者房水中术中FMOX和LVFX的平均浓度分别为1.21±0.63μg/ml和0.69±0.47μg/ml。这些浓度充分超过了对表皮葡萄球菌、金黄色葡萄球菌和痤疮丙酸杆菌的MIC90值。
房水样本中的FMOX和LVFX浓度足以在体外杀灭细菌。这些药物可能对预防白内障手术患者的术后眼内炎有效。
