Antibiotic-impregnated fibrin glue in ocular surgery: In vitro antibacterial activity

A strategy to reduce postoperative ocular infections might consist in maint aining a high antibiotic concentration in the eye by using a topical slow-r elease drug formulation. Fibrin glue is widely used in ocular surgery. Vanc omycin, teicoplanin, cephalothin and gentamicin were added to a 500 IU/ml t hrombin solution, their concentrations in 1 g fibrin glue being 500 mu g fo r vancomycin and 400 mu g for the other drugs. The in vitro antibacterial a ctivity of antibiotic-impregnated fibrin glue was evaluated against a recen t clinical isolate of Staphylococcus epidermidis. Moreover the antibiotic e lution from fibrin discs in saline was assayed for up to 96 h. Fibrin glue properties were maintained when thrombin was reconstituted with a CaCl2 sol ution additioned with the antibiotics tested. All antibiotic fibrin mixture s exhibited good antistaphylococcal activity immediately after the preparat ion. A prolonged inhibition (4 days) of S. epidermidis growth was observed with teicoplanin discs. Gentamicin and teicoplanin levels were higher than those of the other antibiotics. The results suggest that the fibrin glycope ptide and/or gentamicin mixtures can be used, both prophylactically and the rapeutically, in ocular surgery.