Teshigawara Takeshi, Hata Seiichiro, Hayashi Takahiko, Watanabe Yoichiro, Itoh Yoshiki, Hitoi Kazuo, Mizuki Nobuhisa
Yokosuka Chuoh Eye Clinic, Kanagawa, Japan.
Ocul Immunol Inflamm. 2007 Jul-Aug;15(4):309-13. doi: 10.1080/09273940701346338.
The authors topically administered gatifloxacin (GFLX) into the eye before cataract surgery and measured the concentrations of this agent to determine its penetration into aqueous humor. Seventy-seven patients with age-related cataracts who underwent cataract surgery were enrolled in this study. They received 0.3% GFLX ophthalmic solution 4 times at 30-min intervals, beginning 2 h before surgery. Aqueous humor was aspirated from the anterior chamber and assayed for GFLX concentration using high-performance liquid chromatography. The mean intraoperative GFLX concentration in aqueous humor was 0.485 +/- 0.328 microg/mL. GFLX level was 0.573 +/- 0.367 microg/mL in elderly patients, at least 70 years of age, and was significantly higher than that (0.322 +/- 0.135 microg/mL) in the patients less than 70 years old. This concentration was close to or higher than the minimum inhibitory concentrations required to inhibit the growth of 90% of major pathogens of endophthalmitis (MIC90), such as Staphylococcus aureus, Streptococcus pneumoniae, and Enterococcus faecalis associated with poor prognosis, other than Staphylococcus epidermidis, Pseudomonas aeruginosa, and MRSA (methicillin-resistant S. aureus) in vitro. The GFLX concentrations found in aqueous humor samples were sufficient to kill bacteria other than S. epidermidis, P. aeruginosa, and MRSA in vitro.
作者在白内障手术前将加替沙星(GFLX)局部应用于眼内,并测量该药物的浓度以确定其在房水中的渗透情况。77例年龄相关性白内障患者接受了白内障手术并纳入本研究。他们在手术前2小时开始,每隔30分钟接受4次0.3%的GFLX眼药水。从前房抽取房水,采用高效液相色谱法测定GFLX浓度。房水中术中GFLX的平均浓度为0.485±0.328μg/mL。70岁及以上老年患者的GFLX水平为0.573±0.367μg/mL,显著高于70岁以下患者(0.322±0.135μg/mL)。该浓度接近或高于抑制眼内炎主要病原体90%生长所需的最低抑菌浓度(MIC90),如金黄色葡萄球菌、肺炎链球菌和粪肠球菌,这些病原体预后较差,但不包括表皮葡萄球菌、铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌(MRSA)。在房水样本中发现的GFLX浓度足以在体外杀死表皮葡萄球菌、铜绿假单胞菌和MRSA以外的细菌。