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Ocular Penetration of Levofloxacin, Ofloxacin and Ciprofloxacin in Eyes with Functioning Filtering Blebs: investigator masked, randomized clinical trial.
  1. Louis B. Cantor (lcantor{at}iupui.edu),
  2. Darrell WuDunn (dwudunn{at}iupui.edu),
  3. Chi-Wah Yung,
  4. Shailaja Valluri,
  5. Yara P Catoira,
  6. Joni S Hoop (jhoop{at}iupui.edu),
  7. Linda S Morgan
  1. Indiana University School of Medicine, United States
  2. Indiana University School of Medicine, United States
  3. Indiana University School of Medicine, United States
  4. Indiana University School of Medicine, United States
  5. Indiana University School of Medicine, United States
  6. Indiana University School of Medicine, United States
  7. Indiana University School of Medicine, United States

    Abstract

    Background/aims: To compare the penetration of levofloxacin, ofloxacin and ciprofloxacin in the aqueous humour of eyes with functioning filtering blebs.

    Methods: In this investigator masked study, 48 patients with functioning filtering blebs requiring cataract surgery were randomised into six groups of eight patients. Groups 1, 2 and 3 received topical ofloxacin 0.3% (Ocuflox®), ciprofloxacin 0.3% (Ciloxan®) and levofloxacin (Quixin®) respectively; Groups 4, 5 and 6 received the same treatment with the corresponding oral dose of ofloxacin 400mg (Floxin®), ciprofloxacin 400mg (Cipro®), and levofloxacin 250mg (Levaquin®). Aqueous antibiotic levels were determined by mass spectrometry of aqueous samples from each patient.

    Results: The mean aqueous level for topical levofloxacin was significantly higher than those achieved by topical ofloxacin or ciprofloxacin (p-value = 0.02 and 0.01, respectively). The combination of topical and oral levofloxacin was significantly higher than topical levofloxacin alone (p = 0.05) and the ciprofloxacin combination (p = 0.003) but not significantly higher than the ofloxacin combination therapy.

    Conclusions: Topical levofloxacin penetrates better than ofloxacin or ciprofloxacin into the aqueous of eyes with functioning filtering blebs. The combination of topical and oral levofloxacin may be preferable in the treatment of bleb-associated infections. NCT 00392275; Clinical trials.gov

    • Levofloxacin
    • filtering surgery
    • fluoroquinolones
    • penetration

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