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F. Paganelli, J. A. Cardillo, L. A. S. Mello, Jr., A. A. Silva, A. G. Oliveira, A. A. Souza-Filho, R. Belfort, Jr.; Sub-Tenon’s Capsule Delivery of Antibiotic in Controlled-Release System. A More Comprehensive and Rational Anti-Infective Prophylaxis Approach for Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5810.
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To compare the aqueous drug bioaviability of one sub-Tenon’s capsule injection of 2 mg-ciprofloxacin in a biodegradable controlled-release system (Duocat) and in its free form with the common practice of dosing conventional 0.3% ciprofloxacin eye drops 6 times a day for infection prophylaxis after cataract surgery
In 30 albino rabbits 2mg/0.1 ml ciprofloxacin-loaded polylactic-co-glycolic acid (PLGA) microspheres (mean size, 2.3 µm), 2mg/0.1ml of conventional ciprofloxacin were injected in the sub-Tenon’s capsule space and the resulting aqueous and vitreous humors pharmacokinetics and bioaviability profile compared with a single 0.3% ciprofloxacin eye drops 6 times a day
Duocat was able to immediately supply higher, steadier and sustained (up to 10 days following a single sub-Tenon’s capsule injection) therapeutic aqueous and vitreous levels of ciprofloxacin compared to its conventional topical delivery. Animals receiving a loading dose of one 0.3% ciprofloxacin drop every 4 hours had an aqueous and vitreous humor ciprofloxacin concentration 8 times lower for the first 24 hours following the initial loading dose, and in average, 4 times lower up to 7 days compared to that after one sub-Tenon’s capsule injection of 2-mg Duocat. A gradually-fading whitish sub-Tenon’s capsule depot bleb was observed for two weeks following Duocat injection. No side effects were observed with both route of administration
Our results suggest that ciprofloxacin in both conventional postoperative eye drops and DuoCat sub-Tenons’s capsule injection may be equally tolerated with a pharmacodynamic performance clearly favoring the Duocat system. This enhanced penetration provides aqueous humor ciprofloxaxin concentrations at or above the bactericidal concentration for a variety of pathogenic microorganisms and may provide greater protection against ocular infection. DuoCat eliminated any noncompliance issues, and with experience, guided by future clinical and experimental studies, the role of this novel system will be more defined
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