Huerva V, Sinués B, del Buey M A, Cristóbal J A, Mínguez E, Lanuza J, Palomar A
Department of Ophthalmology, University Clinic Hospital, Zaragoza, Spain.
J Ocul Pharmacol. 1993 Summer;9(2):167-70. doi: 10.1089/jop.1993.9.167.
Vancomycin is an antibiotic which is especially active against Gram positive bacteria. At present, numerous infections of the anterior segment of the eye are caused by the Staphilococcus aureus and epidermis. Strains which are resistant to methicilin are more and more frequent and for this reason Vancomycin is becoming the antibiotic of choice to combat these infections since no resistance of the Staphilococcus to it has been demonstrated. The authors evaluated the levels of Vancomycin in aqueous humor after the administration of topical eye-drops. For the first two hours after the last administration, levels of 0.52 micrograms/ml were detected. These inhibit the growth of the majority of bacteria sensitive to Vancomycin. Between two and four hours, the levels decreased to 0.15 micrograms/ml; these are therapeutic levels for a large number of Gram positive bacteria. From four hours after the last administration, these levels are undetectable. Due to the success of its penetration, topical administration of Vancomycin should be considered as a therapeutic modality against infections by gram positive bacteria of the anterior segment. The ideal guideline for administration would be one drop every two hours, especially if the infection is severe. In this way, subconjunctival injection could be avoided.
万古霉素是一种对革兰氏阳性菌具有特效的抗生素。目前，眼部前段的许多感染是由金黄色葡萄球菌和表皮葡萄球菌引起的。耐甲氧西林的菌株越来越常见，因此万古霉素正成为对抗这些感染的首选抗生素，因为尚未发现葡萄球菌对其产生耐药性。作者评估了局部滴眼药水后房水中万古霉素的水平。在最后一次给药后的前两小时，检测到的水平为0.52微克/毫升。这些水平可抑制大多数对万古霉素敏感的细菌的生长。在两到四小时之间，水平降至0.15微克/毫升；这些水平对大量革兰氏阳性菌具有治疗作用。在最后一次给药四小时后，这些水平无法检测到。由于其渗透成功，局部应用万古霉素应被视为对抗眼部前段革兰氏阳性菌感染的一种治疗方式。理想的给药方案是每两小时滴一滴，尤其是在感染严重的情况下。这样可以避免结膜下注射。
