In reply
We appreciate the comments from Drs Fiscella and Jensen. The dual-biopsy technique is an optimal method for assessing conjunctival anti-infective concentrations. And, we strongly agree that additional factors should also be considered when evaluating drug efficacy.
Conjunctival drug levels are of particular importance in bacterial conjunctivitis because the conjunctiva is the tissue to which the bacteria adhere—the site of infection. This, of course, is not a difficult concept. We disagree that the formulation concentration differences between 0.5% moxifloxacin and 0.3% gatifloxacin resulted in the difference in conjunctival concentration. In fact, 0.5% levofloxacin had a lower mean conjunctival concentration (2.34 µg/g) than 0.3% gatifloxacin (2.54 µg/g).
The dual-biopsy technique is an excellent method for measuring anti-infective drug concentrations and could also be adapted for any other ophthalmic medication. To obtain an adequate quantity of tissue for analysis, previous methods for assessing conjunctival antibiotic concentrations described 1 large biopsy specimen . . . [Full Text of this Article]
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