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Penetration of Ofloxacin and Ciprofloxacin Into the Aqueous Humor of Eyes With Functioning Filtering Blebs
A Randomized Trial
Louis B. Cantor, MD;
Eric Donnenfeld, MD;
L. Jay Katz, MD;
Winnie L. Gee, MS;
Charles D. Finley, MD;
Vipul K. Lakhani, MD;
Joni Hoop, CCRC;
Kelly Flarty, MS
Arch Ophthalmol. 2001;119:1254-1257.
Objective To determine concentrations of ofloxacin and ciprofloxacin hydrochloride
in aqueous humor after topical or combined topical and oral administration
in eyes with filtering blebs.
Design A prospective, investigator-masked, randomized, controlled comparative
study involving 36 eyes of 34 patients with functioning filtering blebs who
were to undergo cataract surgery. Treatment groups received either topical
ofloxacin or topical ciprofloxacin (instillation of 0.3% ophthalmic solution
every 30 minutes for 4 hours before surgery), or a combined topical plus oral
regimen (ciprofloxacin hydrochloride, four 100-mg tablets, or ofloxacin, one
400-mg tablet, administered 24-26, 12-14, and 2 hours preceding surgery).
The main outcome measure was antibiotic concentration measured by chromatographic
separation and mass spectrometry of aqueous samples obtained during surgery.
Results Topical antibiotic treatment yielded mean concentrations of ofloxacin,
0.75 µg/mL, and ciprofloxacin, 0.21 µg/mL, in aqueous. With combined
topical and oral therapy, significantly more ofloxacin was measured than ciprofloxacin
(3.84 µg/mL vs 0.35 µg/mL [P<.001]).
The combination regimen produced significantly greater ofloxacin levels than
did topical therapy alone (P = .007).
Conclusions Ofloxacin penetrates better than ciprofloxacin into the aqueous of eyes
with filtering blebs, particularly after combined topical and oral administration,
by which ofloxacin reaches more than a 10-fold greater concentration than
does ciprofloxacin. Combined topical and oral therapy with ofloxacin may be
beneficial in the treatment of bleb-associated infections.
From the Department of Ophthalmology, Indiana University School of
Medicine, Indianapolis (Drs Cantor, Finley, and Lakhani, and Ms Hoop); Department
of External Disease/Cornea, Manhattan Eye, Ear and Throat Hospital (Dr Donnenfeld),
and Cornea Department, North Shore University Hospital (Dr Donnenfeld), New
York, NY; Wills Eye Hospital (Dr Katz and Ms Flarty) and Department of Ophthalmology,
Jefferson Medical College (Dr Katz), Philadelphia, Pa; and the Department
of Biopharmaceutical Sciences, University of California, San Francisco (Ms
Gee). The authors have no financial interest in the drugs used in this study.
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