Gomes Rachel Lopes Rodrigues, Viana Rodrigo Galvão, Melo Luiz Alberto Soares, Cruz Alessandro Carvalho, Lima Acácio Alves de Souza, Suenaga Eunice Mayumi, Campos Mauro
Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Hospital de Olhos Paulista, São Paulo, SP, Brazil.
Arq Bras Oftalmol. 2017 Sep-Oct;80(5):300-303. doi: 10.5935/0004-2749.20170073.
To compare the aqueous humor (AH) concentrations of moxifloxacin 0.5% and gatifloxacin 0.3% solutions alone or when treatment was combined with steroids, and to correlate these concentrations with the minimum inhibitory concentrations (MIC) for the most common endophthalmitis-causing organisms.
Patients undergoing phacoemulsification were enrolled to receive one drop of one of the following solutions: moxifloxacin (G1), moxifloxacin + dexamethasone (G2), gatifloxacin (G3), or gatifloxacin + c (G4), every 15 min, 1h before surgery. AH samples were collected before surgery and analyzed using HPLC-tandem mass spectrometry.
The mean antibiotic concentrations in the AH were: G1= 1280.8 ng/mL; G2= 1644.3 ng/mL; G3= 433.7 ng/mL; and G4= 308.1 ng/mL. The mean concentrations statistically differed between G1 and G2 (p=0.01), and G3 and G4 (p=0.008). All samples achieved the MIC for Staphylococcus epidermidis; 100% of the samples from G1 and G2, and 97% from G3 and G4 reached the MIC for fluoroquinolone-sensitive Staphylococcus aureus; 100% of the samples from G1 and G2, 88% from G3, and 72% from G4 reached the MIC for enterococci (p<0.001); and 100% of samples from G1 and G2, 59% from G3, and 36% from G4 reached the MIC for Streptococcus pneumoniae (p<0.001). For fluoroquinolone-resistant S. aureus, 23% from G1, 44% from G2, and no samples from G3 or G4 achieved the MIC (p<0.001).
Moxifloxacin + dexamethasone demonstrated a higher concen-tration in the AH than the moxifloxacin alone. Gatifloxacin + steroids demonstrated less penetration into the anterior chamber than gatifloxacin alone. Moxifloxacin was superior to gatifloxacin considering the MIC for enterococci, S. pneumoniae, and fluoroquinolone-resistant S. aureus.
比较0.5%莫西沙星溶液和0.3%加替沙星溶液单独使用时以及与类固醇联合治疗时房水（AH）中的浓度，并将这些浓度与最常见的引起眼内炎的微生物的最低抑菌浓度（MIC）进行关联。
纳入接受超声乳化术的患者，在手术前1小时，每隔15分钟滴入以下溶液之一：莫西沙星（G1组）、莫西沙星+地塞米松（G2组）、加替沙星（G3组）或加替沙星+c（G4组）一滴。在手术前采集房水样本，并使用高效液相色谱-串联质谱法进行分析。
房水中抗生素的平均浓度为：G1组=1280.8纳克/毫升；G2组=1644.3纳克/毫升；G3组=433.7纳克/毫升；G4组=308.1纳克/毫升。G1组和G2组之间以及G3组和G4组之间的平均浓度在统计学上有差异（p=0.01和p=0.008）。所有样本均达到表皮葡萄球菌的MIC；G1组和G2组的100%样本以及G3组和G4组的97%样本达到对氟喹诺酮敏感的金黄色葡萄球菌的MIC；G1组和G2组的100%样本、G3组的88%样本以及G4组的72%样本达到肠球菌的MIC（p<0.001）；G1组和G2组的100%样本、G3组的59%样本以及G4组的36%样本达到肺炎链球菌的MIC（p<0.001）。对于耐氟喹诺酮的金黄色葡萄球菌，G1组的23%样本、G2组的44%样本达到MIC，而G3组和G4组无样本达到MIC（p<0.001）。
莫西沙星+地塞米松在房水中的浓度高于单独使用莫西沙星。加替沙星+类固醇进入前房的穿透性低于单独使用加替沙星。就肠球菌、肺炎链球菌和耐氟喹诺酮的金黄色葡萄球菌的MIC而言，莫西沙星优于加替沙星。
