Vitreous and aqueous penetration of orally administered moxifloxacin in humans. 2006

V Vedantham, and P Lalitha, and T Velpandian, and S Ghose, and R Mahalakshmi, and K Ramasamy
Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamilnadu, India. drvasumathy@ yahoo.com

OBJECTIVE To investigate the intraocular penetration of moxifloxacin into the aqueous and vitreous after oral administration in humans. METHODS A prospective, nonrandomized study of 27 consecutive patients scheduled for elective parsplana vitrectomy surgery between 1 October and 31 December 2004 was carried out. Aqueous, vitreous, and serum samples were obtained and analysed after oral administration of a single 400 mg tablet of moxifloxacin a few hours before surgery. Assays were performed using high-performance liquid chromatography. RESULTS Mean+/-SD moxifloxacin concentrations in the serum (n=27), aqueous (n=25), and vitreous (n=27) were 1.34+/-0.98, 0.21+/-0.21, and 0.09+/-0.09 microg/ml, respectively. The mean+/-SD sampling times after oral administration of the moxifloxacin tablet for serum, aqueous, and vitreous were 2.02+/-0.51, 1.53+/-0.45, and 1.55+/-0.46 h, respectively. The minimum inhibitory concentration for 90% of isolates (MIC90) was far exceeded in the aqueous for a wide spectrum of key pathogens, whereas it was not exceeded in the vitreous for several organisms. Of note, the MIC90 for Staphylococcus epidermidis was not exceeded in any of the samples. CONCLUSIONS Orally administered moxifloxacin achieves measurable levels in the noninflammed human eye, with the aqueous levels effective against a variety of pathogens. However, the spectrum of coverage does not appropriately encompass the most common causative organisms in endophthalmitis, especially Staphylococcus epidermidis. Further studies are needed to precisely define the role of oral moxifloxacin in the treatment of or prophylaxis against intraocular infections.

UI MeSH Term Description Entries
D008297 Male Males
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011804 Quinolines
D002851 Chromatography, High Pressure Liquid Liquid chromatographic techniques which feature high inlet pressures, high sensitivity, and high speed. Chromatography, High Performance Liquid,Chromatography, High Speed Liquid,Chromatography, Liquid, High Pressure,HPLC,High Performance Liquid Chromatography,High-Performance Liquid Chromatography,UPLC,Ultra Performance Liquid Chromatography,Chromatography, High-Performance Liquid,High-Performance Liquid Chromatographies,Liquid Chromatography, High-Performance
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077266 Moxifloxacin A fluoroquinolone that acts as an inhibitor of DNA TOPOISOMERASE II and is used as a broad-spectrum antibacterial agent. 1-Cyclopropyl--7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinolinecarboxylic acid,Actira,Avalox,Avelox,BAY 12-8039,BAY 128039,BAY-12-8039,BAY-128039,Izilox,Moxifloxacin Hydrochloride,Octegra,Proflox,BAY 12 8039,BAY128039
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations

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