Feiz Vahid, Nijm Lisa, Glickman Randolph D, Morse Lawrence S, Telander David G, Park Susanna S, Polage Christopher R, Christiansen Steven M, Moshirfar Majid
*Department of Ophthalmology, University of California, Davis Medical Center, Sacramento, CA; †Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX; ‡Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, CA; and §Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT.
Cornea. 2013 Oct;32(10):1315-20. doi: 10.1097/ICO.0b013e318298ddf8.
To determine the penetration of orally administered trimethoprim (TMP)-sulfamethoxazole (SMX) into the aqueous and vitreous cavity of noninflamed human eyes.
Nine adult patients undergoing cataract surgery and 10 adult patients undergoing pars plana vitrectomy were given 3 doses of oral TMP-SMX every 12 hours before the surgery. Aqueous and blood samples were collected from patients undergoing cataract surgery; vitreous and blood samples were collected from patients undergoing vitrectomy. The levels of TMP and SMX were analyzed using high-performance liquid chromatography and were compared with the mean minimum inhibitory concentrations (MIC) of potential ocular pathogens.
TMP-SMX was present in all samples. Among eyes undergoing cataract surgery, the mean concentrations of TMP in aqueous and blood were 0.341 ± 0.141 μg/mL (mean ± SD) and 1.501 ± 0.433 μg/mL and of SMX were 5.259 ± 0.929 μg/mL and 11.835 ± 2.100 μg/mL, respectively. Among eyes undergoing vitrectomy, the mean concentrations of TMP in vitreous and blood were 1.864 ± 0.807 μg/mL and 4.591 ± 2.979 μg/mL and of SMX were 5.910 ± 2.705 μg/mL and 39.289 ± 15.469 μg/mL, respectively. MIC levels were achieved against many bacterial pathogens, including methicillin-resistant Staphylococcus aureus.
TMP-SMX penetrates both the aqueous and vitreous cavities when given orally. The components reach therapeutic inhibitory concentrations in the ocular cavity against many potential pathogens.
确定口服甲氧苄啶（TMP）-磺胺甲恶唑（SMX）在未发炎人眼房水和玻璃体腔中的穿透情况。
9例接受白内障手术的成年患者和10例接受玻璃体切割术的成年患者在手术前每12小时口服3剂TMP-SMX。从接受白内障手术的患者中采集房水和血液样本；从接受玻璃体切割术的患者中采集玻璃体和血液样本。使用高效液相色谱法分析TMP和SMX的水平，并与潜在眼部病原体的平均最低抑菌浓度（MIC）进行比较。
所有样本中均存在TMP-SMX。在接受白内障手术的眼中，房水和血液中TMP的平均浓度分别为0.341±0.141μg/mL（平均值±标准差）和1.501±0.433μg/mL，SMX的平均浓度分别为5.259±0.929μg/mL和11.835±2.100μg/mL。在接受玻璃体切割术的眼中，玻璃体和血液中TMP的平均浓度分别为1.864±0.807μg/mL和4.591±2.979μg/mL，SMX的平均浓度分别为5.910±2.705μg/mL和39.289±15.469μg/mL。对包括耐甲氧西林金黄色葡萄球菌在内的许多细菌病原体均达到了MIC水平。
口服TMP-SMX时可穿透房水和玻璃体腔。其成分在眼腔内对许多潜在病原体达到治疗性抑制浓度。
