Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
J Ocul Pharmacol Ther. 2011 Oct;27(5):531-3. doi: 10.1089/jop.2011.0026. Epub 2011 Jul 13.
To investigate the penetration of micafungin, a new class of echinocandin antifungal agent, into the aqueous humor and vitreous after an intravenous administration.
Endogenous endophthalmitis caused by Candida albicans developed bilaterally in a 67-year-old man. Three hours before vitrectomy, the patient received an intravenous injection of 300 mg micafungin. Samples of aqueous and vitreous were collected during the vitrectomy approximately 60 min after the intravenous injection. The concentration of micafungin in both bodies was determined by high-performance liquid chromatography.
The concentration of micafungin was 25.36 μg/mL in the serum, 0.026 μg/mL in the aqueous, and 0.043 μg/mL in the vitreous. The micafungin minimum inhibitory concentration (MIC) against the C. albicans strain isolated from our patient was 0.03 μg/mL. Thus, the micafungin reached the MIC in the vitreous.
We suggest that intravenous micafungin should be considered in mild cases of endogenous fungal endophthalmitis, or be given in combination with other intravitreal antifungal agents with vitrectomy in more severe cases.
研究新型棘白菌素类抗真菌药物米卡芬净静脉给药后在房水和玻璃体内的渗透情况。
一名 67 岁男性双侧发生白色念珠菌性内源性眼内炎。在玻璃体切除术前 3 小时，患者静脉注射 300mg 米卡芬净。在静脉注射后约 60 分钟进行玻璃体切除手术时采集房水和玻璃体液样本。通过高效液相色谱法测定两种体液中米卡芬净的浓度。
血清中米卡芬净的浓度为 25.36μg/mL，房水中为 0.026μg/mL，玻璃体内为 0.043μg/mL。从我们患者分离出的白色念珠菌菌株对米卡芬净的最小抑菌浓度（MIC）为 0.03μg/mL。因此，玻璃体内达到了米卡芬净的 MIC。
我们建议对于轻度内源性真菌性眼内炎，可以考虑静脉给予米卡芬净，或者在更严重的情况下联合玻璃体腔内其他抗真菌药物并进行玻璃体切除术。
