Kowalski Regis P, Romanowski Eric G, Mah Francis S, Yates Kathleen A, Gordon Y Jerold
Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Am J Ophthalmol. 2005 Sep;140(3):497-504. doi: 10.1016/j.ajo.2005.04.015.
To determine whether Vigamox (moxifloxacin 0.5% ophthalmic solution) can be safely injected intracamerally to prevent Staphylococcus aureus endophthalmitis in a rabbit model.
Animal study.
The safety and bactericidal-effectiveness of Vigamox were evaluated in three stages using 189 New Zealand White rabbits. (Stage 1) The toxicity of two intravitreal doses of Vigamox (moxifloxacin 500, 250 microg) was compared with vancomycin (1 mg) and saline. (Stage 2) A reproducible rabbit model of Staphylococcus aureus endophthalmitis was established. (Stage 3) The bactericidal effect of intracameral Vigamox (moxifloxacin 500, 250, 125, 50 microg) was compared with vancomycin (1 mg) and saline. Intracameral antibiotic therapy commenced immediately after Staphylococcus aureus intravitreal challenge (5000 cfu). Toxicity was evaluated by masked clinical examination using a slit-lamp, an indirect ophthalmoscope, and corneal-ultrasound pachymetry. 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 efficacy was determined using intracameral colony counts.
In the toxicity studies without bacterial challenge, the clinical scores of rabbits injected intracamerally with Vigamox were statistically equivalent to rabbits given intracameral vancomycin or saline. In the efficacy studies, eyes treated intravitreally with Vigamox, at all doses, or vancomycin were negative for Staphylococcus aureus and nontreated controls remained culture-positive.
Vigamox appears to be nontoxic for intracameral injection and effective in preventing experimental endophthalmitis in the rabbit model. Further studies will determine the clinical role of intracameral Vigamox for surgical prophylaxis and postoperative therapy.
确定威克适（0.5%莫西沙星滴眼液）能否通过前房内注射安全地预防兔模型中的金黄色葡萄球菌性眼内炎。
动物研究。
使用189只新西兰白兔分三个阶段评估威克适的安全性和杀菌有效性。（第一阶段）将两种玻璃体内注射剂量的威克适（莫西沙星500、250微克）的毒性与万古霉素（1毫克）和生理盐水进行比较。（第二阶段）建立可重复的金黄色葡萄球菌性眼内炎兔模型。（第三阶段）将前房内注射威克适（莫西沙星500、250、125、50微克）的杀菌效果与万古霉素（1毫克）和生理盐水进行比较。在玻璃体内注射金黄色葡萄球菌（5000菌落形成单位）后立即开始前房内抗生素治疗。通过使用裂隙灯、间接检眼镜和角膜超声测厚仪进行的盲法临床检查评估毒性。临床检查包括眼球外部、角膜、前房、玻璃体和视网膜。表现按照0、0.5、1、2和3的严重程度分级。使用前房内菌落计数确定杀菌效果。
在无细菌攻击的毒性研究中，前房内注射威克适的兔子的临床评分在统计学上与前房内注射万古霉素或生理盐水的兔子相当。在有效性研究中，所有剂量的威克适或万古霉素玻璃体内治疗的眼睛金黄色葡萄球菌检测为阴性，未治疗的对照仍培养阳性。
威克适前房内注射似乎无毒，且在兔模型中可有效预防实验性眼内炎。进一步研究将确定前房内注射威克适在手术预防和术后治疗中的临床作用。
