TOPICAL 0-CENTER-DOT 3-PERCENT CIPROFLOXACIN, NORFLOXACIN, AND OFLOXACIN IN TREATMENT OF BACTERIAL KERATITIS - A NEW METHOD FOR COMPARATIVE-EVALUATION OF OCULAR DRUG PENETRATION
Jp. Diamond et al., TOPICAL 0-CENTER-DOT 3-PERCENT CIPROFLOXACIN, NORFLOXACIN, AND OFLOXACIN IN TREATMENT OF BACTERIAL KERATITIS - A NEW METHOD FOR COMPARATIVE-EVALUATION OF OCULAR DRUG PENETRATION, British journal of ophthalmology, 79(6), 1995, pp. 606-609
Aims-This study was designed to assess the relative corneal penetratio
n of topical drops of three antibiotics and to relate those levels to
minimum inhibitory concentrations for organisms associated with bacter
ial keratitis. Methods-Four drops of each of ciprofloxacin, norfloxaci
n, and ofloxacin (0.3% topical ophthalmic preparations) were given to
12 patients undergoing corneal transplantation. After the recipient ti
ssue was removed, corneal drug penetration was measured using high per
formance liquid chromatography. Results-Intracorneal concentrations of
ofloxacin (geometric mean 0.81 mg kg-l) were significantly higher tha
n both ciprofloxacin (0.60 mg kg(-1); p=0.048) and norfloxacin (0.54 m
g kg(-1); p=0.012). Ciprofloxacin and norfloxacin concentrations did n
ot differ significantly (p=0.33). Conclusions-Review of the minimum in
hibitory concentrations of the fluoroquinolones against ocular pathoge
ns reveals that ciprofloxacin is more potent than ofloxacin against ma
ny bacteria; ofloxacin is in turn more potent than norfloxacin. These
data favour the selection of ciprofloxacin and ofloxacin rather than n
orfloxacin for the empirical treatment of corneal infection. The great
er potency of ciprofloxacin offsets the superior penetration of ofloxa
cin. There is a need for improved clinical trial data concerning the u
se of fluoroquinolone eyedrops in ulcerative keratitis; some encouragi
ng data are available for ciprofloxacin but not (in humans) for norflo
xacin or ofloxacin.