Toxicity and Clearance of Intravitreal Cefotetan

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 1990 Jan 1

PMID 2227495

Authors

W Philipp

K Schmid

H J Steiner

B Pumpel

F Allerberger

H P Aichberger

W Mayer

Affiliations

Soon will be listed here.

Abstract

Direct intravitreal injection of antibiotics plays an important role in the management of bacterial endophthalmitis. In the present study we investigated the toxicity and clearance of intravitreally injected cefotetan in a rabbit model. No toxic ocular side effects could be detected by electroretinography (ERG) or light and electron microscopy up to and including a single intravitreal dose of 1000 micrograms. Intravitreal injection of 2000 micrograms cefotetan resulted in mild degeneration of photoreceptor outer segments and, sporadically, in cataract formation. After intravitreal injection of 4000 micrograms, moderate toxic degeneration of photoreceptors occurred, with displacement and mitochondrial swelling of inner segments. In addition, lysosomal lamellar inclusion bodies could be detected in pigment epithelial cells. After a single intravitreal injection of 1000 micrograms cefotetan, concentrations greater than the minimum necessary for the inhibition of most commonly occurring intraocular pathogens (except Pseudomonas aeruginosa and Staphylococcus epidermidis) were maintained in the vitreous humor for greater than 48 h. Cefotetan may be a potentially important drug for intravitreal injection, especially in cases of gram-negative and suspected anaerobic endophthalmitis.

References

Puliafito C, Baker A, Haaf J, Foster C . Infectious endophthalmitis. Review of 36 cases. Ophthalmology. 1982; 89(8):921-9. View

Nelsen P, Peyman G, Bennett T . BB-K8: A new aminoglycoside for intravitreal injection in bacterial endophthalmitis. Am J Ophthalmol. 1974; 78(1):82-9. DOI: 10.1016/0002-9394(74)90013-0. View

Peyman G, Vastine D, Meisels H . The experimental and clinical use of intravitreal antibiotics to treat bacterial and fungal endophthalmitis. Doc Ophthalmol. 1975; 39(1):183-201. DOI: 10.1007/BF00578762. View

Brinton G, Topping T, Hyndiuk R, AABERG T, Reeser F, Abrams G . Posttraumatic endophthalmitis. Arch Ophthalmol. 1984; 102(4):547-50. DOI: 10.1001/archopht.1984.01040030425016. View

Schenk A, Peyman G, Paque J . The intravitreal use of carbenicillin (Geopen) for treatment od pseudomonas endophthalmitis. Acta Ophthalmol (Copenh). 1974; 52(5):707-17. DOI: 10.1111/j.1755-3768.1974.tb01105.x. View

Hattenhauer J, Lipsich M . Late endophthalmitis after filtering surgery. Am J Ophthalmol. 1971; 72(6):1097-101. DOI: 10.1016/0002-9394(71)91215-3. View

Rutgard J, Berkowitz R, Peyman G . Intravitreal cephalothin in experimental staphylococcal endophthalmitis. Ann Ophthalmol. 1978; 10(3):293-8. View

Ernest J . In vivo measurement of optic-disk oxygen tension. Invest Ophthalmol. 1973; 12(12):927-31. View

Phillips I, King A, Shannon K, Warren C . Cefotetan: in-vitro antibacterial activity and susceptibility to beta-lactamases. J Antimicrob Chemother. 1983; 11 Suppl:1-9. DOI: 10.1093/jac/11.suppl_a.1. View

10.

Ruckdeschel G . Activity in vitro of cefotetan against non-sporing anaerobes: a comparative study. J Antimicrob Chemother. 1983; 11 Suppl:117-24. DOI: 10.1093/jac/11.suppl_a.117. View

11.

Jones D, Robinson N . Anaerobic ocular infections. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977; 83(2):309-31. View

12.

Baum J, Peyman G, Barza M . Intravitreal administration of antibiotic in the treatment of bacterial endophthalmitis. III. Consensus. Surv Ophthalmol. 1982; 26(4):204-6. DOI: 10.1016/0039-6257(82)90080-7. View

13.

Forster R, ABBOTT R, Gelender H . Management of infectious endophthalmitis. Ophthalmology. 1980; 87(4):313-9. DOI: 10.1016/s0161-6420(80)35241-x. View

14.

Bartlett J . Recent developments in the management of anaerobic infections. Rev Infect Dis. 1983; 5(2):235-45. DOI: 10.1093/clinids/5.2.235. View

15.

Peyman G . Antibiotic administration in the treatment of bacterial endophthalmitis. II. Intravitreal injections. Surv Ophthalmol. 1977; 21(4):332, 339-46. View

16.

ALLEN H, MANGIARACINE A . BACTERIAL ENDOPHTHALMITIS AFTER CATARACT EXTRACTION. A STUDY OF 22 INFECTIONS IN 20,000 OPERATIONS. Arch Ophthalmol. 1964; 72:454-62. DOI: 10.1001/archopht.1964.00970020454003. View

17.

Barza M, Kane A, Baum J . Pharmacokinetics of intravitreal carbenicillin, cefazolin, and gentamicin in rhesus monkeys. Invest Ophthalmol Vis Sci. 1983; 24(12):1602-6. View

18.

Sasovetz D . Ketamine hydrochloride: an effective general anesthetic for use in electroretinography. Ann Ophthalmol. 1978; 10(11):1510-4. View

19.

Bauernfeind A . Cefotetan: profile of in-vitro activity. J Antimicrob Chemother. 1983; 11 Suppl:19-29. DOI: 10.1093/jac/11.suppl_a.19. View

20.

Werner H . Inhibitory activity of cefotetan and other beta-lactams against anaerobes. J Antimicrob Chemother. 1983; 11 Suppl:107-15. DOI: 10.1093/jac/11.suppl_a.107. View