[Cefmenoxime penetration in human lacrimal sac mucosa after systemic administration]

Access to microbiological, pharmacokinetic and toxicological information is necessary for useful, controlled application of antibiotics in intraocular and periocular infections. It is important to know whether the antibiotic is effective against ophthalmologically relevant bacteria and if suprathreshold concentrations of the antibiotic can be achieved in the contaminated tissue. In the study presented we investigated the usefulness of cefmenoxime in cases of dacryocystitis. Lacrimal sac tissue--and serum specimens were obtained from 15 patients who underwent dacryocystorhinostomy 0.5 to 13 h after intravenous injection of 25 mg cefmenoxime kg. The usual Toti procedure was performed in 7 patients, whereas the other 8 underwent endonasal surgery. Out of the 15 patients 12 suffered from recurrent dacryocystitis. Before application of the antibiotic a serum control sample was obtained in all patients. The highest cefmenoxime levels in the lacrimal sac (72 mg/kg) were measured 30 min after injection. Thirteen hours after the injection, the cefmenoxime levels were too low to be measured. The levels of cefmenoxime in the lacrimal sac tissue were compared with the minimal inhibitory concentrations for the frequent occurrence of bacteria in lacrimal sac infections.