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SM Hariprasad, WF Mieler, SG Schwartz, D Barrow, XK Sun, DP Nicolau, ER Holz; Vitreous Penetration of Orally Administered Gatifloxacin in Humans . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4430.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the penetration of gatifloxacin, a novel extended-spectrum fluoroquinolone antibiotic, into the vitreous humor after oral administration. Methods: A prospective, non-randomized clinical study of ten consecutive patients scheduled for vitrectomy surgery between September 2001 and December 2001 at the Cullen Eye Institute / Baylor College of Medicine Department of Ophthalmology. Aqueous, vitreous, and serum samples were obtained and analyzed from ten patients after oral administration of two 400 mg gatifloxacin tablets taken 12 hours apart before surgery. Assays were performed using high-performance liquid chromatography. Results: Mean gatifloxacin concentrations in serum (n=10), vitreous (n=10), and aqueous (n=6) were 5.33 1.02 ug/ml, 1.33 0.39 ug/ml, and 1.15 0.70 ug/ml respectively. Mean sampling times after oral administration of the second gatifloxacin tablet for serum, vitreous, and aqueous were 2.95 0.78 hours, 3.84 0.87 hours, and 3.57 0.77 hours respectively. The percentages of serum gatifloxacin concentration achieved in the vitreous and aqueous were 24.90% and 21.55% respectively. Mean inhibitory vitreous and aqueous MIC90 levels were achieved against a wide spectrum of pathogens including Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Propionibacterium acnes, Haemophilus influenzae, Escherichia coli, Bacillus cereus, Neisseria gonorrhoeae, Proteus mirabilis, and other organisms. Conclusion: Gatifloxacin is a novel fourth generation fluoroquinolone antibiotic which has MIC90 levels significantly lower than other fluoroquinolone agents. Furthermore, it penetrates well into the non-inflamed eye. Potential uses for oral gatifloxacin may include prophylaxis against endophthalmitis in open-globe injuries, surgical prophylaxis against post-operative endophthalmitis, and adjunctive therapy for the current treatment of endophthalmitis.
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