Abstract
Objective: To determine whether intravitreal dexamethasone administration can alter the elimination of intravitreal vancomycin hydrochloride in rabbit eyes with experimental Streptococcus pneumoniae endophthalmitis. Methods: Albino rabbits were infected with an intravitreal inoculum of S pneumoniae (2 x 103 colony-forming units) and randomized after 24 hours to treatment with intravitreal vancomycin hydrochloride (1 mg), alone or in combination with intravitreal dexamethasone (400 μg). For comparison, uninfected eyes were similarly treated. All eyes were enucleated 24, 48, or 72 hours after treatment, and vitreous levels of vancomycin were quantitated using a fluorescence polarizing immunoassay. Results: The half- life of intravitreal vancomycin in infected eyes was prolonged from 48 to 84 hours when eyes were treated with dexamethasone. Conversely, such treatment shortened the half-life in uninfected eyes from 56 to 42 hours. Conclusions: Intravitreal dexamethasone administration reduces the elimination of intravitreal vancomycin in rabbit eyes with pneumococcal endophthalmitis, whereas an opposite effect is noted in uninfected eyes. Clinical Relevance: In patients with eyes having endophthalmitis caused by virulent organisms, the elimination of intravitreal vancomycin may be reduced when intraocular inflammation is minimized with corticosteroid therapy. This may enhance the efficacy of intravitreal vancomycin therapy in treating the infection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1058-1062 |
| Number of pages | 5 |
| Journal | Archives of Ophthalmology |
| Volume | 117 |
| Issue number | 8 |
| State | Published - Aug 1999 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Ophthalmology
Cite this
Intravitreal dexamethasone effect on intravitreal vancomycin elimination in endophthalmitis. / Park, Susanna Soon Chun; Vallar, Robert V.; Hong, Chian Huey; Von Gunten, Sylviane; Ruoff, Kate; D'Amico, Donald J.
In: Archives of Ophthalmology, Vol. 117, No. 8, 08.1999, p. 1058-1062.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intravitreal dexamethasone effect on intravitreal vancomycin elimination in endophthalmitis
AU - Park, Susanna Soon Chun
AU - Vallar, Robert V.
AU - Hong, Chian Huey
AU - Von Gunten, Sylviane
AU - Ruoff, Kate
AU - D'Amico, Donald J.
PY - 1999/8
Y1 - 1999/8
N2 - Objective: To determine whether intravitreal dexamethasone administration can alter the elimination of intravitreal vancomycin hydrochloride in rabbit eyes with experimental Streptococcus pneumoniae endophthalmitis. Methods: Albino rabbits were infected with an intravitreal inoculum of S pneumoniae (2 x 103 colony-forming units) and randomized after 24 hours to treatment with intravitreal vancomycin hydrochloride (1 mg), alone or in combination with intravitreal dexamethasone (400 μg). For comparison, uninfected eyes were similarly treated. All eyes were enucleated 24, 48, or 72 hours after treatment, and vitreous levels of vancomycin were quantitated using a fluorescence polarizing immunoassay. Results: The half- life of intravitreal vancomycin in infected eyes was prolonged from 48 to 84 hours when eyes were treated with dexamethasone. Conversely, such treatment shortened the half-life in uninfected eyes from 56 to 42 hours. Conclusions: Intravitreal dexamethasone administration reduces the elimination of intravitreal vancomycin in rabbit eyes with pneumococcal endophthalmitis, whereas an opposite effect is noted in uninfected eyes. Clinical Relevance: In patients with eyes having endophthalmitis caused by virulent organisms, the elimination of intravitreal vancomycin may be reduced when intraocular inflammation is minimized with corticosteroid therapy. This may enhance the efficacy of intravitreal vancomycin therapy in treating the infection.
AB - Objective: To determine whether intravitreal dexamethasone administration can alter the elimination of intravitreal vancomycin hydrochloride in rabbit eyes with experimental Streptococcus pneumoniae endophthalmitis. Methods: Albino rabbits were infected with an intravitreal inoculum of S pneumoniae (2 x 103 colony-forming units) and randomized after 24 hours to treatment with intravitreal vancomycin hydrochloride (1 mg), alone or in combination with intravitreal dexamethasone (400 μg). For comparison, uninfected eyes were similarly treated. All eyes were enucleated 24, 48, or 72 hours after treatment, and vitreous levels of vancomycin were quantitated using a fluorescence polarizing immunoassay. Results: The half- life of intravitreal vancomycin in infected eyes was prolonged from 48 to 84 hours when eyes were treated with dexamethasone. Conversely, such treatment shortened the half-life in uninfected eyes from 56 to 42 hours. Conclusions: Intravitreal dexamethasone administration reduces the elimination of intravitreal vancomycin in rabbit eyes with pneumococcal endophthalmitis, whereas an opposite effect is noted in uninfected eyes. Clinical Relevance: In patients with eyes having endophthalmitis caused by virulent organisms, the elimination of intravitreal vancomycin may be reduced when intraocular inflammation is minimized with corticosteroid therapy. This may enhance the efficacy of intravitreal vancomycin therapy in treating the infection.
UR - http://www.scopus.com/inward/record.url?scp=0032811912&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032811912&partnerID=8YFLogxK
M3 - Article
C2 - 10448749
AN - SCOPUS:0032811912
VL - 117
SP - 1058
EP - 1062
JO - JAMA Ophthalmology
JF - JAMA Ophthalmology
SN - 2168-6165
IS - 8
ER -