Levofloxacin disposition over time in aqueous humor of patients undergoing cataract surgery

Abstract

The ocular disposition of levofloxacin in patients receiving two 500-mg oral doses 10 h apart before cataract surgery was assessed with the intent of defining drug ocular exposure over time. The mean aqueous humor concentrations persisted above 1.5 mg/liter between 1.5 and 6.0 h after the second dose, with average aqueous-to-plasma ratios ranging between 0.33 and 0.57. This favorable ocular disposition provides support for trials of systemic levofloxacin for prophylaxis of postoperative endophthalmitis in selected patients or as adjunctive therapy for the treatment of this potentially devastating infective complication.

Figures

FIG. 1.

Levofloxacin concentrations in plasma and aqueous humor samples from patients undergoing cataract surgery (n = 101). Mean values ± SD (error bars) are shown. Reference lines show the MIC90s for levofloxacin (2) of the principal etiological agents of endophthalmitis (Streptococcus pneumoniae, Streptococcus pyogenes, methicillin-sensitive [MS] Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis).

FIG. 2.

Relationship between aqueous humor and plasma concentrations of levofloxacin in patients undergoing cataract surgery (n = 101).