K. Mahlberg et al., COMPATIBILITY OF CORTICOSTEROIDS AND ANTIBIOTICS IN COMBINATION, Journal of cataract and refractive surgery, 23(6), 1997, pp. 878-882
Purpose: To study the compatibility of combinations of antibiotics and
steroids commonly used in anterior segment surgery. Setting: Research
Laboratory, Helsinki University, Finland. Methods: Aggregate producti
on in vitro and in vivo was studied for three injectable antibiotics (
cefotaxime sodium, tobramycin sulfate, and gentamicin) and four cortic
osteroids (triamcinolone acetonide, methylprednisolone sodium succinat
e, methylprednisolone acetate, and dexamethasone sodium phosphate) usi
ng conventional and dark-field microscopy. Aggregate formation on coll
agen shields and subconjunctival aggregate formation of tobramycin sul
fate in combination with methylprednisolone acetate or dexamethasone s
odium phosphate was also studied. Results: Dexamethasone sodium phosph
ate (4 mg/mL) did not form aggregates with any of the three antibiotic
s tested. Cefotaxime sodium did not cause aggregates when 24 mg/mL of
dexamethasone sodium phosphate was used both in vitro and in vivo or i
n association with collagen shields. Conclusions: To avoid undesired s
ide effects, such as epithelial sloughing and corneal edema after coll
agen shield application, antibiotics and steroids must be carefully se
lected.