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Published on: July 23, 2016
Intraocular vancomycin levels after intravitreal injection in post cataract extraction endophthalmitis
S A Haider1, P Hassett, A J Bron
1Institute of Ophthalmology, Mayo Hospital, Lahore, Pakistan.
Retina (Philadelphia, Pa.)
|June 26, 2001
Summary
Intraocular vancomycin levels after intravitreal injections for endophthalmitis vary widely but remain therapeutic. Monitoring these levels can guide optimal timing for repeat vancomycin injections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pharmacology
Background:
- Intravitreal antibiotics are crucial for treating post-cataract surgery endophthalmitis.
- Understanding vancomycin concentration is key to effective treatment and preventing toxicity.
Purpose of the Study:
- To determine the range of intraocular vancomycin levels following intravitreal therapy.
- To assess the optimal timing for repeat vancomycin injections in endophthalmitis cases.
Main Methods:
- Aqueous and vitreous vancomycin levels were measured in 14 patients with poor clinical response to initial treatment.
- Patients received either 1 mg or 2 mg of vancomycin, with repeat injections at 48 or 72 hours.
Main Results:
- Aqueous vancomycin levels ranged from 8.4 to 170 mg/L.
- Vitreous vancomycin levels ranged from 21.2 to 220 mg/L, sometimes exceeding 100 mg/L.
- Higher aqueous levels were observed with a 2 mg dose compared to a 1 mg dose.
Conclusions:
- Vitreous vancomycin levels are variable but generally therapeutic for Gram-positive organisms.
- Vancomycin levels can exceed potentially retinotoxic levels.
- Assaying vancomycin at repeat injection times can inform treatment adequacy and guide future therapy.
