Penetration of topically applied gatifloxacin 0.3%, moxifloxacin 0.5%, and ciprofloxacin 0.3% into the aqueous humor

Abstract

Abstract: : Purpose: To investigate the aqueous penetration of three commercially available ophthalmic fluoroquinolones. Methods: In a prospective, double masked study 52 patients undergoing cataract surgery were given preoperative topical gatifloxacin 0.3% (Zymar^TM ), moxifloxacin 0.5% (Vigamox^TM ), or ciprofloxacin 0.3% (Ciloxan^TM ). The patients were instructed to use their antibiotic drops four times a day for 3 days prior to surgery. On the day of surgery patients were given their assigned antibiotic every 15 minutes for one hour one hour prior to their procedure. At the time of surgery, 0.1 ml of aqueous fluid was aspirated from the anterior chamber via an air cannula needle attached to a tuberculin syringe. This was immediately stored at –70 degrees Centigrade. Fluoroquinolone concentrations were determined by using reversed phase high–pressure liquid chromatography assay technique with ultraviolet detection at a wavelength of 275nm. Results: Mean aqueous concentration of gatifloxacin in 16 eyes was 0.63 mcg/ml (SD 0.30), moxifloxacin in 14 eyes was 1.31 mcg/ml (SD 0.46) and the mean concentration of ciprofloxacin in 22 eyes was 0.15 mcg/ml (SD 0.11). Conclusions: Both moxifloxacin (P<0.001) and gatifloxacin (P<0.005) penetrated into the aqueous humor significantly better than ciprofloxacin. Moxifloxacin penetrated into the aqueous humor significantly better than gatifloxacin (P <0.05). The anterior chamber levels of moxifloxacin and gatifloxacin may be due to the difference in antibiotic concentration and may not reflect an intrinsic difference in solubility.

Keywords: antibiotics/antifungals/antiparasitics • clinical research methodology • pharmacology